Q91 ICD-10-CM Code: Trisomy 18 and Trisomy 13
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Coding at a Glance
- Tabular directives
- 1 Excludes2
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Q91 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on Q91 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.
- mitochondrial metabolic disorders (E88.4-) Compare Q91 vs E88.4 →
Source: inherited from Q90-Q99
Coder workflow for Q91
MedCoder structured workflow — derived from this code’s own official record
Before you code Q91
- Q91 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).
ReviewQ91.0, Q91.1, Q91.2, Q91.3, Q91.4, Q91.5, Q91.6, Q91.7
See the relationships section · Guide: How to choose an ICD-10-CM code →
Choose the right path
- Does the documentation support one of the more specific codes beneath Q91?
Yes → Select that code and continue the checks below on its own page.
No → Q91 cannot be reported as written; query for the specificity its subcategory needs.ReviewQ91.0, Q91.1, Q91.2, Q91.3, Q91.4, Q91.5, Q91.6, Q91.7
Consider Q91. Then confirm the code is valid for the date of service in the Verify section.
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).
Official instructions as workflow
Excludes2 — not part of Q91(1 note)
Coding workflow: The conditions named in this note are not included in Q91. 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
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.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Verify Before Coding
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 structured relationships — computed from published CMS and AHRQ datasets
Other codes that name Q91 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, Q50 — Congenital malformations of ovaries, fallopian tubes and broad ligaments, Q50-Q56 — Congenital malformations of genital organs (Q50-Q56), Q51 — Congenital malformations of uterus and cervix, Q52 — Other congenital malformations of female genitalia, Q53 — Undescended and ectopic testicle, Q54 — Hypospadias, Q55 — Other congenital malformations of male genital organs, Q56 — Indeterminate sex and pseudohermaphroditism, Q92 — Other trisomies and partial trisomies of the autosomes, not elsewhere classified, Z15 — Genetic susceptibility to disease.
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.
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.
Contextual Map
Every relationship of Q91 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 Q91 with these 10 related codes in Claim Check
Hierarchy
- Q00-QA1 — Chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-QA1) (Q00-QA1)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q90-Q99 — Chromosomal abnormalities, not elsewhere classified[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Excludes2
- E88.4 — Mitochondrial metabolism disorders[Excludes2]: “mitochondrial metabolic disorders (E88.4-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes1 notes (11)
- E25 — Adrenogenital disorders[Excludes1]: “chromosomal abnormalities (Q90-Q99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q50 — Congenital malformations of ovaries, fallopian tubes and broad ligaments[Excludes1]: “syndromes associated with anomalies in the number and form of chromosomes (Q90-Q99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q50-Q56 — Congenital malformations of genital organs (Q50-Q56)[Excludes1]: “syndromes associated with anomalies in the number and form of chromosomes (Q90-Q99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q51 — Congenital malformations of uterus and cervix[Excludes1]: “syndromes associated with anomalies in the number and form of chromosomes (Q90-Q99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q52 — Other congenital malformations of female genitalia[Excludes1]: “syndromes associated with anomalies in the number and form of chromosomes (Q90-Q99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q53 — Undescended and ectopic testicle[Excludes1]: “syndromes associated with anomalies in the number and form of chromosomes (Q90-Q99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q54 — Hypospadias[Excludes1]: “syndromes associated with anomalies in the number and form of chromosomes (Q90-Q99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q55 — Other congenital malformations of male genital organs[Excludes1]: “syndromes associated with anomalies in the number and form of chromosomes (Q90-Q99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- and 3 more
Referenced by Code First instructions
- D84.81 — Immunodeficiency due to conditions classified elsewhere[Code First]: “chromosomal abnormalities (Q90-Q99)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Nearest codes
- Q91.0 — Trisomy 18, nonmosaicism (meiotic nondisjunction)[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q91.1 — Trisomy 18, mosaicism (mitotic nondisjunction)[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q91.2 — Trisomy 18, translocation[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q91.3 — Trisomy 18, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q91.4 — Trisomy 13, nonmosaicism (meiotic nondisjunction)[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q91.5 — Trisomy 13, mosaicism (mitotic nondisjunction)[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q91.6 — Trisomy 13, translocation[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q91.7 — Trisomy 13, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Common coding questions
Can Q91 be billed directly?
No. Q91 (Trisomy 18 and Trisomy 13) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
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 FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) 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 structured 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 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.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
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. "Q91 — Trisomy 18 and Trisomy 13." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/q91-trisomy-18-and-trisomy-13
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionTrisomy 18 and Trisomy 13
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), 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 Q91 in its code family, with their registry titles.
- 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