Q79.4 ICD-10-CM Code: Prune belly syndrome
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0) / Congenital malformations and deformations of the musculoskeletal system (Q65-Q79)
Q79.4
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePrune belly syndrome
A rare birth defect characterized by weak or absent abdominal muscles, a wrinkled appearance of the abdomen, and often associated with urinary tract and reproductive system abnormalities.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 64
Varies by metal level
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Congenital prolapse of bladder mucosa
- Eagle-Barrett syndrome
Excludes 2
Official- congenital (sternomastoid) torticollis (Q68.0)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Q79.4 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Q79.4 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Q79.4 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Q79.4 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Q79.4 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is Q79.4 an HCC code?
No. Q79.4 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- Q79.4
- Description
- Prune belly syndrome
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
Get the V28 RAF + MEAT cheat sheet
One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.
Free PDF. No card. Unsubscribe anytime.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Q79.4 is the ICD-10-CM diagnosis code for prune belly syndrome. A rare birth defect characterized by weak or absent abdominal muscles, a wrinkled appearance of the abdomen, and often associated with urinary tract and reproductive system abnormalities. Q79.4 sits in the ICD-10-CM chapter for congenital malformations, deformations and chromosomal abnormalities (q00-qa0), within the section covering congenital malformations and deformations of the musculoskeletal system (q65-q79).
Q79.4 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
This condition is also known as Eagle-Barrett syndrome; document associated urological and reproductive abnormalities separately.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q79.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This condition is also known as Eagle-Barrett syndrome; document associated urological and reproductive abnormalities separately
- •Severity varies widely; note whether the condition affects kidney function or requires surgical intervention