ICD-10 · PDGM grouping
Q86 Congenital malformation syndromes due to known exogenous causes, not elsewhere classified
All 4 codes in the Q86 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
4
Can lead a claim
4
Cannot lead a claim
0
What CMS assigns to Q86
All 4 codes group to MMTA - Other. None of the 4 is assigned a comorbidity subgroup. Every code can lead a claim.
Every code in Q86
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 |
|---|---|---|---|---|
| Q86.0 | Fetal alcohol syndrome (dysmorphic) | Can lead a claim | A | None |
| Q86.1 | Fetal hydantoin syndrome | Can lead a claim | A | None |
| Q86.2 | Dysmorphism due to warfarin | Can lead a claim | A | None |
| Q86.8 | Other congenital malformation syndromes due to known exogenous causesCMS: Oth congen malform syndromes due to known exogenous causes | Can lead a claim | A | 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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