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QA0.0142 ICD-10-CM Code: DLG4-related synaptopathy

ICD-10-CM Code View

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FY 2026 Apr update / Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0) / Genetic disorders, not elsewhere classified (QA0)

QA0.0142

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

DLG4-related synaptopathy

A neurodevelopmental disorder caused by mutations in the DLG4 gene, which affects the structure and function of connections between nerve cells, leading to developmental and intellectual disabilities.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

HCC 97

Varies by metal level

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
QA0.01Neurodevelopmental disorders related to pathogenic variants in certain specific genes
QA0.014Neurodevelopmental disorders, related to pathogenic variants in synapse related genes
QA0.0142DLG4-related synaptopathy

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for QA0.0142 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for QA0.0142 in this effective period.

Related Child Codes

Official
QA0.0141Syntaxin-binding protein 1-related disorder
QA0.0149Neurodevelopmental disorder, related to pathogenic variant in other synapse related gene

Includes

Official

ICD-10-CM does not list Includes notes for QA0.0142 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for QA0.0142 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for QA0.0142 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for QA0.0142 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for QA0.0142 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Ensure genetic testing documentation confirms DLG4 pathogenic variant
Link with codes for intellectual disability, developmental delay, or autism spectrum disorder as applicable

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is QA0.0142 an HCC code?

No. QA0.0142 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

QA0.0142 is the ICD-10-CM diagnosis code for dlg4-related synaptopathy. A neurodevelopmental disorder caused by mutations in the DLG4 gene, which affects the structure and function of connections between nerve cells, leading to developmental and intellectual disabilities. QA0.0142 sits in the ICD-10-CM chapter for congenital malformations, deformations and chromosomal abnormalities (q00-qa0), within the section covering genetic disorders, not elsewhere classified (qa0).

QA0.0142 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.

Ensure genetic testing documentation confirms DLG4 pathogenic variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for QA0.0142 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Ensure genetic testing documentation confirms DLG4 pathogenic variant
  • Link with codes for intellectual disability, developmental delay, or autism spectrum disorder as applicable

Child Codes

Code Hierarchy

Work QA0.0142 in HCC Buddy

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