Q87.410
BillableMarfan syndrome with aortic dilation
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Q87.410 an HCC code?
No. Q87.410 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
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 Q87.410
For Q87.410to 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 Q87.410 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
Q87.410 is the ICD-10-CM diagnosis code for marfan syndrome with aortic dilation. Marfan syndrome with aortic dilation, a serious heart condition where the main artery leaving the heart becomes enlarged due to the connective tissue disorder. Q87.410 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 (q80-q89).
Q87.410 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.
Maps to RxHCC 84 (Muscular Dystrophy) with RAF weight 0.0 in the RxHCC model only. Despite the high clinical risk and intensive monitoring needs, this condition does not contribute to risk adjustment in CMS-HCC models. Coders reviewing Q87.410 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC — capturing the correct specificity is the highest-leverage RAF improvement available within accurate coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q87.410 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always document the degree of aortic dilation and monitor for aortic dissection risk
- •Coordinate with cardiology for management; this is a critical manifestation requiring close follow-up
Clinical Significance
Marfan syndrome with aortic dilation represents a high-risk cardiovascular condition requiring urgent monitoring and intervention. Aortic dilation can progress to life-threatening aortic dissection or rupture, making this a critical diagnosis for care management and risk stratification.
Documentation Requirements
- ✓Confirmed diagnosis of Marfan syndrome
- ✓Echocardiogram or CT/MRI showing aortic dilation measurements
- ✓Specific documentation of aortic root dimensions
- ✓Serial imaging studies tracking aortic size progression
- ✓Cardiology consultation notes
- ✓Assessment of surgical intervention candidacy
- ✓Documentation of activity restrictions
- ✓Family screening recommendations