Q97.1
BillableFemale with more than three X chromosomes
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Q97.1 an HCC code?
No. Q97.1 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
Q97.1 is the ICD-10-CM diagnosis code for female with more than three x chromosomes. A rare chromosomal condition where a person has more than three X chromosomes (such as 48, XXXX or 49, XXXXX), causing developmental and physical effects. Q97.1 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).
Q97.1 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 rare condition; document the exact number of X chromosomes from genetic testing.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q97.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a rare condition; document the exact number of X chromosomes from genetic testing
- •Severity typically increases with the number of additional X chromosomes