ICD-10 · PDGM grouping
Q55 Other congenital malformations of male genital organs
All 18 codes in the Q55 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
18
Can lead a claim
16
Cannot lead a claim
2
What CMS assigns to Q55
16 of the 18 codes group to MMTA - Other; 2 are assigned no clinical group. None of the 18 is assigned a comorbidity subgroup. 16 of the 18 can lead a claim. CMS attaches a code-first note to 1 of the 18.
Code first
CMS grouper convention 150, on Q55.3. Code first:
- any associated cystic fibrosis (E84.-)
Every code in Q55
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| Q55.0 | Absence and aplasia of testis | Can lead a claim | A | None |
| Q55.1 | Hypoplasia of testis and scrotum | Can lead a claim | A | None |
| Q55.2 Other and unspecified congenital malformations of testis and scrotum | ||||
| Q55.20 | Unspecified congenital malformations of testis and scrotum | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Q55.21 | Polyorchism | Can lead a claim | A | None |
| Q55.22 | Retractile testis | Can lead a claim | A | None |
| Q55.23 | Scrotal transposition | Can lead a claim | A | None |
| Q55.29 | Other congenital malformations of testis and scrotum | Can lead a claim | A | None |
| Q55.3 | Atresia of vas deferens | Can lead a claim, code first applies | A | None |
| Q55.4 | Other congenital malformations of vas deferens, epididymis, seminal vesicles and prostateCMS: Oth congen malform of vas def,epidid, semnl vescl & prostate | Can lead a claim | A | None |
| Q55.5 | Congenital absence and aplasia of penis | Can lead a claim | A | None |
| Q55.6 Other congenital malformations of penis | ||||
| Q55.61 | Curvature of penis (lateral) | Can lead a claim | A | None |
| Q55.62 | Hypoplasia of penis | Can lead a claim | A | None |
| Q55.63 | Congenital torsion of penis | Can lead a claim | A | None |
| Q55.64 | Hidden penis | Can lead a claim | A | None |
| Q55.69 | Other congenital malformation of penis | Can lead a claim | A | None |
| Q55.7 | Congenital vasocutaneous fistula | Can lead a claim | A | None |
| Q55.8 | Other specified congenital malformations of male genital organsCMS: Oth congenital malformations of male genital organs | Can lead a claim | A | None |
| Q55.9 | Congenital malformation of male genital organ, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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