2025 ICD-10-CM code Q90.9
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Congenital malformations, deformations and chromosomal abnormalities - Chromosomal abnormalities, not elsewhere classified Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99) Feed
Down syndrome, unspecified; Trisomy 21 NOS.
Medical necessity for coding Q90.9 is established by the presence of clinical findings consistent with Down syndrome, confirmed ideally through genetic testing. The code is used for accurate diagnosis and tracking of the condition's prevalence and associated health issues.
The clinical responsibility for coding Q90.9 rests with the physician or healthcare provider who establishes the diagnosis of Down syndrome.This involves a thorough clinical evaluation, including physical examination, genetic testing (karyotyping), and assessment of developmental milestones.
- Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- Q90-Q99 (Chromosomal abnormalities, not elsewhere classified)
In simple words: This code is for Down syndrome when the exact type isn't specified. Down syndrome is a genetic condition causing developmental delays and physical characteristics.Doctors might use this code if they need to note Down syndrome without specifying a particular kind.
This code classifies Down syndrome, unspecified, also known as Trisomy 21, not otherwise specified.It's used when the specific type of Down syndrome isn't known or documented.Additional codes should be used to specify associated physical conditions (e.g., atrioventricular septal defect) and any associated intellectual disabilities.
Example 1: A newborn infant presents with characteristic facial features (flattened nasal bridge, upward slanting palpebral fissures, small ears) and hypotonia. Karyotyping confirms Trisomy 21.Code Q90.9 is assigned., A child with Down syndrome is evaluated for developmental delays.The specific type of Down syndrome is not specified in the medical record. Code Q90.9 is used, along with codes for the associated intellectual disability and any other related conditions., An adult with Down syndrome is admitted to the hospital for pneumonia. The medical record only notes Down syndrome without further specification. Code Q90.9 is assigned along with the code for pneumonia.
Complete documentation is essential and should include:* Detailed clinical findings from physical examination.* Results of genetic testing (karyotype analysis) if performed.* Assessment of developmental milestones and intellectual function.* Description of associated congenital anomalies or medical conditions.
** Excludes: Inborn errors of metabolism (E70-E88); Mitochondrial metabolic disorders (E88.4-).
- Payment Status: Active
- Specialties:Genetics, Pediatrics, Obstetrics, General Practice
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital