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Q93.52 ICD-10-CM Code: Phelan-McDermid syndrome

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

Coding at a Glance

Tabular directives
1 inclusion term · 1 Excludes2 · 5 use-additional codes
Risk adjustment
RxHCC V08 category 148

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 Q93.52 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 Q93.52 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • 22q13.3 deletion syndrome

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

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code(s) to identify any associated conditions, such as:
  • autism spectrum disorder (F84.0)
  • degree of intellectual disabilities (F70-F79)
  • epilepsy and recurrent seizures (G40.-)
  • lymphedema (I89.0)

Coder workflow for Q93.52

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 Q93.52(1 note)

    Coding workflow: The conditions named in this note are not included in Q93.52. 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 Q93.52(5 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with Q93.52 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewF84.0, G40, I89.0

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

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 Q93.52?

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).

ReviewF84.0, G40, I89.0

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 Q93.52 with…

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

The codes most likely to be picked instead of Q93.52 — 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.

  • 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: Q93.52 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.

Code Overview

Phelan-McDermid syndrome is a billable ICD-10-CM diagnosis code (Q93.52).

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

Indexed Clinical Terms (3)

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.

Verify Before Coding

  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

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 Q93.52 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 10 Excludes1 notes across 3 chapters: E25 — Adrenogenital disorders (via Q93.-), Q50 — Congenital malformations of ovaries, fallopian tubes and broad ligaments (via Q93.-), Q50-Q56 — Congenital malformations of genital organs (Q50-Q56) (via Q93.-), Q51 — Congenital malformations of uterus and cervix (via Q93.-), Q52 — Other congenital malformations of female genitalia (via Q93.-), Q53 — Undescended and ectopic testicle (via Q93.-), Q54 — Hypospadias (via Q93.-), Q55 — Other congenital malformations of male genital organs (via Q93.-), Q56 — Indeterminate sex and pseudohermaphroditism (via Q93.-), Z15 — Genetic susceptibility to disease (via Q93.-).

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 Q93.-).

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: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 68 clinically related codes on its CMS exclusion list.

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 process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

Q92.62 — Marker chromosomes in abnormal individual, Q92.7 — Triploidy and polyploidy, Q92.8 — Other specified trisomies and partial trisomies of autosomes, Q92.9 — Trisomy and partial trisomy of autosomes, unspecified, Q93.0 — Whole chromosome monosomy, nonmosaicism (meiotic nondisjunction), Q93.1 — Whole chromosome monosomy, mosaicism (mitotic nondisjunction), Q93.2 — Chromosome replaced with ring, dicentric or isochromosome, Q93.3 — Deletion of short arm of chromosome 4, Q93.4 — Deletion of short arm of chromosome 5, Q93.51 — Angelman syndrome, Q93.59 — Other deletions of part of a chromosome, Q93.7 — Deletions with other complex rearrangements, Q93.81 — Velo-cardio-facial syndrome, Q93.82 — Williams syndrome, Q93.88 — Other microdeletions, Q93.89 — Other deletions from the autosomes, Q93.9 — Deletion from autosomes, unspecified, Q95.0 — Balanced translocation and insertion in normal individual, Q95.1 — Chromosome inversion in normal individual, Q95.2 — Balanced autosomal rearrangement in abnormal individual, +47 more

Same clinical category (CCSR)

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

Q92.7 — Triploidy and polyploidy, Q92.8 — Other specified trisomies and partial trisomies of autosomes, Q92.9 — Trisomy and partial trisomy of autosomes, unspecified, Q93.0 — Whole chromosome monosomy, nonmosaicism (meiotic nondisjunction), Q93.1 — Whole chromosome monosomy, mosaicism (mitotic nondisjunction), Q93.2 — Chromosome replaced with ring, dicentric or isochromosome, Q93.3 — Deletion of short arm of chromosome 4, Q93.4 — Deletion of short arm of chromosome 5, Q93.5 — Other deletions of part of a chromosome, Q93.51 — Angelman syndrome, Q93.59 — Other deletions of part of a chromosome, Q93.7 — Deletions with other complex rearrangements, Q93.81 — Velo-cardio-facial syndrome, Q93.82 — Williams syndrome, Q93.88 — Other microdeletions, Q93.89 — Other deletions from the autosomes, Q93.9 — Deletion from autosomes, unspecified, Q95.0 — Balanced translocation and insertion in normal individual, Q95.1 — Chromosome inversion in normal individual, Q95.2 — Balanced autosomal rearrangement in abnormal individual, +56 more

Contextual Map

Every relationship of Q93.52 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 Q93.52 with these 17 related codes in Claim Check

Hierarchy

Use Additional Code (9)

Referenced by Excludes1 notes (10)

Referenced by Code First instructions

Clinical classification (CCSR)

MS-DRG Grouper

  • CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2027
  • DRG 884 — ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY[MS-DRG]: “ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY (MDC 19)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027

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

  • Phelan-McDermid syndrome[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Syndrome, 22q13.3 deletion[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Syndrome, Phelan-McDermid[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (16)

Change history

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 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. "Q93.52 — Phelan-McDermid syndrome." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/q93.52-phelan-mcdermid-syndrome

Change history

  • FY2024 — October 1, 2023
    Added to the code set
    Phelan-McDermid syndrome
    FY2024 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Q93.52 in its code family, with their registry titles.

View all codes in the Q93 family