Q97.9
BillableSex chromosome abnormality, female phenotype, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Q97.9 an HCC code?
No. Q97.9 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
Q97.9 is the ICD-10-CM diagnosis code for sex chromosome abnormality, female phenotype, unspecified. A chromosomal condition affecting females where there is a sex chromosome abnormality, but the specific type has not been identified or specified. Q97.9 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).
Q97.9 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 default code used when the type of sex chromosome abnormality in females is unknown or unspecified.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q97.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a default code used when the type of sex chromosome abnormality in females is unknown or unspecified
- •Attempt to obtain more specific documentation before using this code; query the provider if additional testing results are available