Q87.85
BillableMED13L syndrome
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Q87.85 an HCC code?
No. Q87.85 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Q87.85 is the ICD-10-CM diagnosis code for med13l syndrome. MED13L syndrome is a rare genetic disorder affecting development and causing intellectual disability, developmental delay, and distinctive facial features. Q87.85 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).
Q87.85 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 is a recently identified genetic syndrome; ensure accurate documentation of the specific diagnosis.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q87.85 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a recently identified genetic syndrome; ensure accurate documentation of the specific diagnosis
- •Code developmental delays and intellectual disability separately using appropriate F-codes