2027 ICD-10-CM Diagnosis Code Q56.4Indeterminate sex, unspecified
ICD-10-CM Codes›Q00-Q99›Q50-Q56›Q56
- Billable — Valid for Submission
- POA Exempt
- Chronic Condition
Q56.4 is a billable ICD-10-CM diagnosis code for indeterminate sex, unspecified. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 729 through 730, 742 through 743, 760 through 761. The code is exempt from POA reporting. Coders also document this condition as ambiguous genitalia. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Genitourinary congenital anomalies.
Code Identity
Code Classification
Present on Admission (POA)Billing
Q56.4 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Congenital malformations of genital organs (Q50-Q56).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Ambiguous genitalia
- Finding related to biological sex
- Indeterminate sex
- SCARF syndrome
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Q56.4: its own notes plus those printed at Q56, block Q50-Q56, and Chapter 17. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Ambiguous genitalia
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Notes
General instructions on how these codes are used.
- Codes from this chapter are not for use on maternal records
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Q56.4, its category, or a range that includes it.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Ambiguous genitalia Q56.4
Indeterminate sex Q56.4
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Birth Defects
A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of pregnancy. One out of every 33 babies in the United States is born with a birth defect.
The full article covers:
- What are birth defects?
- What causes birth defects?
- Who is at risk of having a baby with birth defects?
- How are birth defects diagnosed?
- What are the treatments for birth defects?
- Can birth defects be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Q56.4 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Q56.4Overview
What is the ICD-10 code for indeterminate sex, unspecified?
The ICD-10-CM code for indeterminate sex, unspecified is Q56.4 (sometimes written as Q564). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Q56.4 (Indeterminate sex and pseudohermaphroditism) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report indeterminate sex, unspecified on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Q56.4 group to?
When indeterminate sex, unspecified is the principal diagnosis on an inpatient stay, it groups to MS-DRG 742, 729, 743, 760, 761, 730, with relative weights from 0.6595 to 1.8448 depending on complications. Higher weights mean higher Medicare reimbursement.
Is Q56.4 exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for indeterminate sex, unspecified on inpatient claims. The code appears in the Congenital malformations of genital organs (Q50-Q56) range of the CMS exempt list.
Can Q56.4 be reported with Q99.1?
Not as a rule. The Excludes1 note at Q56, which applies to Q56.4, lists "46,XX true hermaphrodite (Q99.1)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
