2027 ICD-10-CM Diagnosis Code Q93.52Phelan-McDermid syndrome

ICD-10-CM Codes›Q00-Q99›Q90-Q99›Q93

ICD-10-CM Q93.52
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Q93.52 is a billable ICD-10-CM diagnosis code for Phelan-McDermid syndrome. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 884. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 68 closely related codes. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Chromosomal abnormalities.

Q93.52 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 148 for payment year 2027.

Code Identity

ICD-10-CM Code
Q93.52
Billable Status
Yes — Valid for Submission
Code Describes
Phelan-McDermid syndrome
Short Description
Phelan-McDermid syndrome
Same as the full description in the CMS dataset.
Parent Code
Q93.5
Other deletions of part of a chromosome

Code Classification

ChapterQ00-Q99Congenital malformations, deformations and chromosomal abnormalities
SectionQ90-Q99Chromosomal abnormalities, not elsewhere classified
CategoryQ93Monosomies and deletions from the autosomes, not elsewhere classified
This CodeQ93.52Phelan-McDermid syndrome

Present on Admission (POA)Billing

Q93.52 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Chromosomal abnormalities, not elsewhere classified (Q90-Q99).

Medicare Risk Adjustment (HCC)Billing

Q93.52 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model, but it maps to payment categories in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
no payment category in the model that pays 100% of MA risk scores
Prior Model (CMS-HCC V24)
Not mapped under V24
this diagnosis newly risk-adjusts under the V28 model
Part D (RxHCC)
RxHCC 148 — Mild or Unspecified Intellectual Disability/Developmental Disorder
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Q93.52: its own notes plus those printed at block Q90-Q99 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.

  • 22q13.3 deletion syndrome

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.

From Block Q90-Q99 Chromosomal abnormalities, not elsewhere classified applies to 74 codes
  • mitochondrial metabolic disorders (E88.4-)
From Chapter 17 (Q00-QA1) Congenital malformations, deformations and chromosomal abnormalities applies to 900 codes
  • inborn errors of metabolism (E70-E88)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

  • code(s) to identify any associated conditions, such as:
  • autism spectrum disorder (F84.0)
  • degree of intellectual disabilities (F70-F79)
  • epilepsy and recurrent seizures (G40.-)
  • lymphedema (I89.0)

Notes

General instructions on how these codes are used.

From Chapter 17 (Q00-QA1) Congenital malformations, deformations and chromosomal abnormalities applies to 900 codes
  • 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 Q93.52, its category, or a range that includes it.

Excludes1 3

These codes carry an Excludes1 note naming Q93.52: they are not reported together with it, unless the two conditions are unrelated.

  • E25 Adrenogenital disorders
    chromosomal abnormalities (Q90-Q99) names Q90-Q99, which includes this code
  • Block Q50-Q56 Congenital malformations of genital organs
    syndromes associated with anomalies in the number and form of chromosomes (Q90-Q99) names Q90-Q99, which includes this code
  • Z15 Genetic susceptibility to disease
    chromosomal anomalies (Q90-Q99) names Q90-Q99, which includes this code

Code First 1

These codes say to code first a condition named in the note, and Q93.52 is one of the conditions named.

  • D84.81 Immunodeficiency due to conditions classified elsewhere
    chromosomal abnormalities (Q90-Q99) names Q90-Q99, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MAL009
Chromosomal abnormalities
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Phelan-McDermid Syndrome

    an autosomal dominant condition caused by mutation(s) and or deletion of the shank3 gene, encoding sh3 and multiple ankyrin repeat domains protein 3. it is characterized by variable features, which may include intellectual disability, autism spectrum disorder, developmental delay and mild dysmorphic features.

Code History & ChangesHistory

Replacement Q93.52 replaces the following previously assigned code(s):

  • Q93.59 - Other deletions of part of a chromosome
FY 2024AddedAdded to the ICD-10-CM code setEffective October 1, 2023.
FY 2025–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Q93.52Overview

What is the ICD-10 code for Phelan-McDermid syndrome?

The ICD-10-CM code for Phelan-McDermid syndrome is Q93.52 (sometimes written as Q9352). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is Q93.52 (Other deletions of part of a chromosome) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report Phelan-McDermid syndrome on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Q93.52 group to?

When Phelan-McDermid syndrome is the principal diagnosis on an inpatient stay, it groups to MS-DRG 884 (organic Disturbances and Intellectual Disability), which carries a relative weight of 1.5998. Higher weights mean higher Medicare reimbursement.

Is Q93.52 a CC or MCC?

CMS lists Q93.52 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 68 closely related codes in its exclusion list.

Is Q93.52 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 Phelan-McDermid syndrome on inpatient claims. The code appears in the Chromosomal abnormalities, not elsewhere classified (Q90-Q99) range of the CMS exempt list.

Does Q93.52 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage: Q93.52 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 148 (Mild or Unspecified Intellectual Disability/Developmental Disorder).