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Q90.2 ICD-10-CM Code: Trisomy 21, translocation

Compare with another code for Q90.2Check this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Official instructions
1 Excludes2 · 1 use-additional instruction · 1 code-also instruction

What these terms mean →

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Use additional codefrom Q90Report with this code when documented
  • Use additional code(s) to identify any associated degree of intellectual disabilities (F70-F79)
Code alsofrom Q90May be needed with this code
  • associated physical condition(s), such as atrioventricular septal defect (Q21.2-)
Excludes2from Q90-Q99Not included here; may be reported together
  • mitochondrial metabolic disorders (E88.4-)

Where it sits Source: CMS/NCHS

Under:Chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-QA1) (Q00-QA1)Q90-Q99 Chromosomal abnormalities, not elsewhere classifiedQ90 Down syndrome

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 884 — ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY (MDC 19)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Q90.2 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on Q90.2 itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from Q90-Q99

Code Also

Additional codes that may be required to fully describe the encounter.

  • associated physical condition(s), such as atrioventricular septal defect (Q21.2-)

Source: inherited from Q90

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code(s) to identify any associated degree of intellectual disabilities (F70-F79)

Source: inherited from Q90

Coder workflow for Q90.2

MedCoder structured workflow — derived from this code’s own official record

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes2 — not part of Q90.2(1 note)

    Coding workflow: The conditions named in this note are not included in Q90.2. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareE88.4

    See the official tabular notes · Guidelines I.A.12.b

  • Use Additional Code — after identifying Q90.2(1 note)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with Q90.2 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    See the official tabular notes · Guidelines I.A.13

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewQ21.2

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with Q90.2?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse Q90.2 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of Q90.2 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • Q90.9— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Down syndrome, unspecified” takes Q90.9; specificity in the record moves it back here.

    Full comparison: Q90.2 vs Q90.9 →

  • E88.4— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of mitochondrial metabolic disorders adds E88.4; it is not part of this code and both may be reported when both are documented.

    Full comparison: Q90.2 vs E88.4 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Trisomy 21, translocation is a billable ICD-10-CM diagnosis code (Q90.2).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 1 Use Additional Code instruction — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  2. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  3. 1 Excludes2 entry — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name Q90.2 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 11 Excludes1 notes across 3 chapters: E25 — Adrenogenital disorders (via Q90.-), Q50 — Congenital malformations of ovaries, fallopian tubes and broad ligaments (via Q90.-), Q50-Q56 — Congenital malformations of genital organs (Q50-Q56) (via Q90.-), Q51 — Congenital malformations of uterus and cervix (via Q90.-), Q52 — Other congenital malformations of female genitalia (via Q90.-), Q53 — Undescended and ectopic testicle (via Q90.-), Q54 — Hypospadias (via Q90.-), Q55 — Other congenital malformations of male genital organs (via Q90.-), Q56 — Indeterminate sex and pseudohermaphroditism (via Q90.-), Q92 — Other trisomies and partial trisomies of the autosomes, not elsewhere classified (via Q90.-), Z15 — Genetic susceptibility to disease (via Q90.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Code First instruction: D84.81 — Immunodeficiency due to conditions classified elsewhere (via Q90.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 1 MS-DRG: DRG 884 (MDC 19).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):MAL009 — Chromosomal abnormalities (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Chromosomal abnormalities).

Q87.86 — Kleefstra syndrome, Q90.0 — Trisomy 21, nonmosaicism (meiotic nondisjunction), Q90.1 — Trisomy 21, mosaicism (mitotic nondisjunction), Q90.9 — Down syndrome, unspecified, Q91.0 — Trisomy 18, nonmosaicism (meiotic nondisjunction), Q91.1 — Trisomy 18, mosaicism (mitotic nondisjunction), Q91.2 — Trisomy 18, translocation, Q91.3 — Trisomy 18, unspecified, Q91.4 — Trisomy 13, nonmosaicism (meiotic nondisjunction), Q91.5 — Trisomy 13, mosaicism (mitotic nondisjunction), Q91.6 — Trisomy 13, translocation, Q91.7 — Trisomy 13, unspecified, Q92.0 — Whole chromosome trisomy, nonmosaicism (meiotic nondisjunction), Q92.1 — Whole chromosome trisomy, mosaicism (mitotic nondisjunction), Q92.2 — Partial trisomy, Q92.5 — Duplications with other complex rearrangements, Q92.61 — Marker chromosomes in normal individual, Q92.62 — Marker chromosomes in abnormal individual, Q92.7 — Triploidy and polyploidy, Q92.8 — Other specified trisomies and partial trisomies of autosomes, +56 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Trisomy”, “Translocation”; these codes share that main term but sit in a different category of the Tabular List.

Q91.0 — Trisomy 18, nonmosaicism (meiotic nondisjunction) (18, meiotic nondisjunction), Q91.1 — Trisomy 18, mosaicism (mitotic nondisjunction) (18, mosaicism), Q91.2 — Trisomy 18, translocation (18, translocation), Q91.3 — Trisomy 18, unspecified (18), Q91.4 — Trisomy 13, nonmosaicism (meiotic nondisjunction) (13, meiotic nondisjunction), Q91.5 — Trisomy 13, mosaicism (mitotic nondisjunction) (13, mosaicism), Q91.6 — Trisomy 13, translocation (13, translocation), Q91.7 — Trisomy 13, unspecified (13), Q92.0 — Whole chromosome trisomy, nonmosaicism (meiotic nondisjunction) (whole chromosome, meiotic nondisjunction), Q92.1 — Whole chromosome trisomy, mosaicism (mitotic nondisjunction) (whole chromosome, mosaicism), Q92.2 — Partial trisomy (chromosome specified NEC, partial), Q92.5 — Duplications with other complex rearrangements (chromosome specified NEC, partial, due to unbalanced translocation), Q92.8 — Other specified trisomies and partial trisomies of autosomes (22), Q92.9 — Trisomy and partial trisomy of autosomes, unspecified, Q95.0 — Balanced translocation and insertion in normal individual (balanced autosomal, in normal individual), Q95.9 — Balanced rearrangement and structural marker, unspecified (balanced autosomal), Q99.8 — Other specified chromosome abnormalities (chromosomes NEC)

Contextual Map

Every relationship of Q90.2 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run Q90.2 with these 9 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes (11)

Referenced by Code First instructions

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 19 — Mental Diseases and Disorders[MDC crossing]: “Mental Diseases and Disorders — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Down syndrome, translocation[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Syndrome, trisomy, 21, translocation[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Translocation, Down syndrome[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Translocation, trisomy, 21[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Trisomy (syndrome), 21 (partial), translocation[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (5)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "Q90.2 — Trisomy 21, translocation." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/q90.2-trisomy-21-translocation

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Trisomy 21, translocation

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Q90.2 in its code family, with their registry titles.

View all codes in the Q90 family