Q86.0 — Fetal alcohol syndrome (dysmorphic)
Q86.0 is a billable, specific ICD-10-CM code for fetal alcohol syndrome (dysmorphic). It is valid for submission on a claim.
Other codes that can never be billed with Q86.0
These codes carry an Excludes1 note pointing at Q86.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Q86.0 alone.
- P04.3Newborn affected by maternal use of alcohol
Risk adjustment
Q86.0 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
Q86.0 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57189Billing and Coding: Serum Magnesium
How Q86.0 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Q86.0.
- Dysmorphism›alcohol
- Fetus, fetal›alcohol syndrome(dysmorphic)
- Syndrome›fetal›alcohol(dysmorphic)
- Syndrome›malformation, congenital, due to›alcohol
Related codes at this level
Codes that share Q86. If Q86.0 is not quite right, the correct code is usually one of these.
Questions about Q86.0
- Is Q86.0 a billable ICD-10-CM code?
- Yes. Q86.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Q86.0 sit in the tabular list?
- Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Other congenital malformations (Q80-Q89).