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Q92.2

Billable

Partial trisomy

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is Q92.2 an HCC code?

No. Q92.2 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

HCC Category Mapping

RxHCCHCC 148Mild Intellectual Disabilities
0.000

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 Q92.2

For Q92.2to 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 Q92.2 during that encounter — not just copy-forwarded from a problem list.

What This Code Means

Q92.2 is the ICD-10-CM diagnosis code for partial trisomy. A chromosomal condition where a person has three copies of only a portion or segment of a chromosome rather than the entire chromosome. Q92.2 sits in the ICD-10-CM chapter for congenital malformations, deformations, chromosomal abnormalities, and genetic disorders (q00-qa0), within the section covering chromosomal abnormalities, not elsewhere classified (q90-q99).

Q92.2 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 148 (Mild Intellectual Disabilities) with RAF weight 0.0 in the RxHCC model only. The condition does not impact CMS-HCC models despite potential for developmental delays and need for specialized services. Coders reviewing Q92.2 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 Q92.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Document which chromosome and which segment is duplicated for specificity
  • Partial trisomies often have less severe effects than whole chromosome trisomies

Clinical Significance

Partial trisomy involves duplication of only a chromosome segment rather than the entire chromosome, often resulting in variable clinical presentation depending on the size and gene content of the duplicated region. This condition requires specific genetic analysis to predict phenotypic effects and guide management.

Documentation Requirements

  • Chromosomal microarray or karyotype showing partial duplication
  • Documentation of specific chromosome region duplicated
  • Size of duplicated segment if available
  • Clinical features present
  • Developmental assessment results
  • Comparison with known duplication syndromes
  • Genetic counseling regarding recurrence risk
  • Family history of chromosomal abnormalities

Excludes 1 — Do NOT code together

  • partial trisomy due to unbalanced translocation (Q92.5)

Commonly Confused Codes

  • Q92.0 — Whole chromosome trisomy, nonmosaicism (complete chromosome)
  • Q92.5 — Duplications with complex rearrangements (additional structural changes)
  • Q99.8 — Other specified chromosome abnormalities
  • Q93.9 — Deletion syndrome, unspecified (loss vs gain of material)

Code Hierarchy

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