Q44.71
BillableAlagille syndrome
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Q44.71 an HCC code?
Yes. Q44.71 maps to Cholangitis and Biliary Cirrhosis under the CMS-HCC V28 risk adjustment model.
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for Q44.71
For Q44.71 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed Q44.71 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
Q44.71 is the ICD-10-CM diagnosis code for alagille syndrome. A rare genetic birth defect affecting the liver, bile ducts, heart, face, and skeleton, characterized by distinctive facial features and liver abnormalities. Q44.71 sits in the ICD-10-CM chapter for congenital malformations, deformations, chromosomal abnormalities, and genetic disorders (q00-qa0), within the section covering other congenital malformations of the digestive system (q38-q45).
Under the CMS-HCC V28 risk adjustment model, Q44.71 maps to Cholangitis and Biliary Cirrhosis (HCC 68) with a community, non-dual, aged base RAF weight of 0.000. Q44.71 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Alagille syndrome is a multi-system disorder; code all affected systems separately. Because Q44.71 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q44.71 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Alagille syndrome is a multi-system disorder; code all affected systems separately
- •This is a specific genetic syndrome with characteristic features documented in medical literature
Clinical Significance
Alagille syndrome is a rare multisystem genetic disorder with significant morbidity affecting liver, heart, kidneys, and other organs, requiring coordinated multidisciplinary care throughout life. The syndrome carries substantial risk for liver failure requiring transplantation and cardiac complications, making accurate diagnosis crucial for comprehensive management and family counseling.
Documentation Requirements
- ✓Confirmation of Alagille syndrome diagnosis with genetic testing
- ✓Documentation of characteristic facial features
- ✓Liver involvement with bile duct paucity on biopsy
- ✓Cardiac abnormalities (pulmonary stenosis, etc.)
- ✓Renal involvement and function assessment
- ✓Skeletal abnormalities (butterfly vertebrae)
- ✓Ophthalmologic findings (posterior embryotoxon)
- ✓Family history and genetic counseling documentation