ICD-10-CM Code Q86.0

Fetal alcohol syndrome (dysmorphic)

Version 2020 Billable Code POA Exempt

Valid for Submission

Q86.0 is a billable code used to specify a medical diagnosis of fetal alcohol syndrome (dysmorphic). The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Q86.0 might also be used to specify conditions or terms like fetal alcohol spectrum disorder or fetal alcohol syndrome or fetal or neonatal effect of alcohol transmitted via placenta and/or breast milk or fetal or neonatal effect of maternal use of alcohol. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

ICD-10:Q86.0
Short Description:Fetal alcohol syndrome (dysmorphic)
Long Description:Fetal alcohol syndrome (dysmorphic)

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Q86.0 are found in the index:


Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Fetal Alcohol Spectrum Disorder
  • Fetal alcohol syndrome
  • Fetal or neonatal effect of alcohol transmitted via placenta and/or breast milk
  • Fetal or neonatal effect of maternal use of alcohol

Clinical Information

  • FETAL ALCOHOL SPECTRUM DISORDERS-. an umbrella term used to describe a pattern of disabilities and abnormalities that result from fetal exposure to ethanol during pregnancy. it encompasses a phenotypic range that can vary greatly between individuals but reliably includes one or more of the following: characteristic facial dysmorphism fetal growth retardation central nervous system abnormalities cognitive and/or behavioral dysfunction birth defects. the level of maternal alcohol consumption does not necessarily correlate directly with disease severity.

Present on Admission (POA)

Q86.0 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Q86.0 to ICD-9

  • 760.71 - Maternl alc aff NB/fetus (Approximate Flag)

Code Classification

  • Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
    • Other congenital malformations (Q80-Q89)
      • Congen malform syndromes due to known exogenous causes, NEC (Q86)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Fetal Alcohol Spectrum Disorders

Alcohol can harm your baby at any stage during a pregnancy. That includes the earliest stages, before you even know you are pregnant. Drinking during pregnancy can cause a group of conditions called fetal alcohol spectrum disorders (FASDs). Children who are born with FASD can have a mix of problems, such as medical, behavioral, educational, and social problems. The kinds of problems they have depend on which type of FASD they have. The problems could include

  • Abnormal facial features, such as a smooth ridge between the nose and upper lip
  • Small head size
  • Shorter-than-average height
  • Low body weight
  • Poor coordination
  • Hyperactive behavior
  • Difficulty with attention and memory
  • Learning disabilities and difficulty in school
  • Speech and language delays
  • Intellectual disability or low IQ
  • Poor reasoning and judgment skills
  • Sleep and sucking problems as a baby
  • Vision or hearing problems
  • Problems with the heart, kidneys, or bones

Fetal alcohol syndrome (FAS) is the most serious type of FASD. People with fetal alcohol syndrome have facial abnormalities, including wide-set and narrow eyes, growth problems and nervous system abnormalities.

Diagnosing FASD can be hard because there is no medical test for it. The health care provider will make a diagnosis by looking at the child's signs and symptoms, and will ask whether the mother drank alcohol during pregnancy.

FASDs last a lifetime. There is no cure for FASDs, but treatments can help. These include medicines to help with some symptoms, medical care for health problems, behavior and education therapy, and parent training. A good treatment plan is specific to the child's problems. It should include close monitoring, follow-ups, and changes when needed.

Certain "protective factors" can help reduce the effects of FASDs and help people who have them reach their full potential. They include

  • Diagnosis before 6 years of age
  • Loving, nurturing, and stable home environment during the school years
  • Absence of violence around them
  • Involvement in special education and social services

There is no known safe amount of alcohol during pregnancy. To prevent FASDs, you should not drink alcohol while you are pregnant, or when you might get pregnant.

Centers for Disease Control and Prevention


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