Is ICD-10-CM code Q56 billable?

No, Q56 (Indeterminate sex and pseudohermaphroditism) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code Q56 belong to?

Q56 belongs to Chapter 17 of the ICD-10-CM tabular list: Q00–Q99 (Congenital Malformations, Deformations and Chromosomal Abnormalities).

Q56Not billable, use a more specific code below

Indeterminate sex and pseudohermaphroditism

In Congenital malformations of genital organs (Q50-Q56), chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities

5 billable codes under Q56: none are a CC or MCC; none map to an HCC.

Instructional notes

Excludes1: not coded here, use a different code

46,XX true hermaphrodite (Q99.1)
androgen insensitivity syndrome (E34.5-)
chimera 46,XX/46,XY true hermaphrodite (Q99.0)
female pseudohermaphroditism with adrenocortical disorder (E25.-)
pseudohermaphroditism with specified chromosomal anomaly (Q96-Q99)
pure gonadal dysgenesis (Q99.1)

Also applies, from Congenital malformations of genital organs (Q50-Q56)

These notes sit on Q50-Q56 and apply to every code under it, including Q56.

Excludes1: not coded here, use a different code

androgen insensitivity syndrome (E34.5-)
syndromes associated with anomalies in the number and form of chromosomes (Q90-Q99)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Assign Q00-QA1 codes for documented congenital anomalies or genetic disorders at any age, coding non-inherent manifestations separately and sequencing Z38 first on the birth admission.

Read Section I.C.17 (page 74)

All codes under Q56

Q56 can't be used on a claim. Pick a billable code below; grey headings group them.

Q56 MS-DRGs

As the principal diagnosis, the billable codes under Q56 group to MS-DRG 729, 730, 742, 743, 760, or 761 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 729 Other Male Reproductive System Diagnoses with CC/MCC (4 of 5 codes)
DRG 730 Other Male Reproductive System Diagnoses without CC/MCC (4 of 5 codes)
DRG 742 Uterine and Adnexa Procedures for Non-Malignancy with CC/MCC (4 of 5 codes)
DRG 743 Uterine and Adnexa Procedures for Non-Malignancy without CC/MCC (4 of 5 codes)
DRG 760 Menstrual and Other Female Reproductive System Disorders with CC/MCC (4 of 5 codes)
DRG 761 Menstrual and Other Female Reproductive System Disorders without CC/MCC (4 of 5 codes)

Other codes that refer to Q56

Notes on these codes point to Q56.

E25 Excludes1: indeterminate sex and pseudohermaphroditism (Q56)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Birth Defects

A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of pregnancy. One out of every 33 babies in the United States is born with a birth defect.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.