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Q95.9 ICD-10-CM Code: Balanced rearrangement and structural marker, unspecified

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

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 v43, Appendix B.

  • MS-DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)

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 Q95.9 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 Q95.9 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • Robertsonian and balanced reciprocal translocations and insertions

Source: inherited from Q95

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

Coder workflow for Q95.9

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

Before you code Q95.9

  1. Unspecified does not mean incorrect. When the record gives no greater specificity, Q95.9 may be the appropriate code. Check the record for detail that supports a more specific sibling. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

    ReviewQ95.0, Q95.1, Q95.2, Q95.3, Q95.5, Q95.8

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

Choose the right path

  1. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — Q95.9 is appropriate when the documentation goes no further.

    ReviewQ95.0, Q95.1, Q95.2, Q95.3, Q95.5, Q95.8

Consider Q95.9. 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).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes2 — not part of Q95.9(1 note)

    Coding workflow: The conditions named in this note are not included in Q95.9. 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

Coding decision scenarios

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

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific sibling code supportable?

Path: Review the specific siblings in this subcategory and what each requires the record to state.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

ReviewQ95.0, Q95.1, Q95.2, Q95.3, Q95.5, Q95.8

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

Balanced rearrangement and structural marker, unspecified is a billable ICD-10-CM diagnosis code (Q95.9).

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 (2)

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

  • 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 structured relationships — computed from published CMS and AHRQ datasets

Other codes that name Q95.9 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 Q95.-), Q50 — Congenital malformations of ovaries, fallopian tubes and broad ligaments (via Q95.-), Q50-Q56 — Congenital malformations of genital organs (Q50-Q56) (via Q95.-), Q51 — Congenital malformations of uterus and cervix (via Q95.-), Q52 — Other congenital malformations of female genitalia (via Q95.-), Q53 — Undescended and ectopic testicle (via Q95.-), Q54 — Hypospadias (via Q95.-), Q55 — Other congenital malformations of male genital organs (via Q95.-), Q56 — Indeterminate sex and pseudohermaphroditism (via Q95.-), Z15 — Genetic susceptibility to disease (via Q95.-).

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 Q95.-).

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 (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 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 951 (MDC 23).

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).

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, Q95.3 — Balanced sex/autosomal rearrangement in abnormal individual, Q95.5 — Individual with autosomal fragile site, Q95.8 — Other balanced rearrangements and structural markers, Q96.0 — Karyotype 45, X, Q96.1 — Karyotype 46, X iso (Xq), Q96.2 — Karyotype 46, X with abnormal sex chromosome, except iso (Xq), Q96.3 — Mosaicism, 45, X/46, XX or XY, Q96.4 — Mosaicism, 45, X/other cell line(s) with abnormal sex chromosome, Q96.8 — Other variants of Turner's syndrome, Q96.9 — Turner's syndrome, unspecified, Q97.0 — Karyotype 47, XXX, Q97.1 — Female with more than three X chromosomes, Q97.2 — Mosaicism, lines with various numbers of X chromosomes, +56 more

Same Index main term, other category

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

Q90.2 — Trisomy 21, translocation (trisomy, 21), Q91.2 — Trisomy 18, translocation (trisomy, 18), Q91.6 — Trisomy 13, translocation (trisomy, 13), Q99.8 — Other specified chromosome abnormalities (chromosomes NEC)

Contextual Map

Every relationship of Q95.9 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 Q95.9 with these 9 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes (10)

Referenced by Code First instructions

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services[MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — 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. 1,235 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Rearrangement, chromosomal, balanced (in)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Translocation, balanced autosomal[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes

Change history

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

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
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 — v43 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. "Q95.9 — Balanced rearrangement and structural marker, unspecified." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/q95.9-balanced-rearrangement-and-structural-marker-unspecified

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Balanced rearrangement and structural marker, unspecified

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 Q95.9 in its code family, with their registry titles.

View all codes in the Q95 family