2027 ICD-10-CM Diagnosis Code Q95.3Balanced sex/autosomal rearrangement in abnormal individual
ICD-10-CM Codes›Q00-Q99›Q90-Q99›Q95
- Billable — Valid for Submission
- POA Exempt
- Chronic Condition
Q95.3 is a billable ICD-10-CM diagnosis code for balanced sex/autosomal rearrangement in abnormal individual. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. The code is exempt from POA reporting. Coders also document this condition as balanced rearrangement and structural marker. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Chromosomal abnormalities.
Q95.3 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
Code Classification
Present on Admission (POA)Billing
Q95.3 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
Q95.3 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.
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.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Balanced rearrangement and structural marker
- Balanced sex/autosomal rearrangement in abnormal individual
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Q95.3: its own notes plus those printed at Q95, block Q90-Q99, and Chapter 17. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- Robertsonian and balanced reciprocal translocations and insertions
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.
- mitochondrial metabolic disorders (E88.4-)
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 Q95.3, its category, or a range that includes it.
Excludes1 3
These codes carry an Excludes1 note naming Q95.3: they are not reported together with it, unless the two conditions are unrelated.
- E25 Adrenogenital disorders
- Block Q50-Q56 Congenital malformations of genital organs
- Z15 Genetic susceptibility to disease
Code First 1
These codes say to code first a condition named in the note, and Q95.3 is one of the conditions named.
- D84.81 Immunodeficiency due to conditions classified elsewhere
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.
Patient EducationClinical
Genetic Disorders
Genetic disorders are health conditions caused by changes (also called mutations or variants) in your genes. Genes are parts of DNA found in your cells that carry instructions for how your body grows, develops, and functions. Many genes tell your body how to make proteins, which are needed for your body to work properly.
The full article covers:
- What are genetic disorders?
- What causes genetic disorders?
- What are the types of genetic disorders?
- What are the different ways a genetic disorder can be inherited?
- How are genetic disorders diagnosed?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Q95.3 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Q95.3Overview
What is the ICD-10 code for balanced sex/autosomal rearrangement in abnormal individual?
The ICD-10-CM code for balanced sex/autosomal rearrangement in abnormal individual is Q95.3 (sometimes written as Q953). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Q95.3 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report balanced sex/autosomal rearrangement in abnormal individual on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Q95.3 group to?
When balanced sex/autosomal rearrangement in abnormal individual is the principal diagnosis on an inpatient stay, it groups to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.
Is Q95.3 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 balanced sex/autosomal rearrangement in abnormal individual on inpatient claims. The code appears in the Chromosomal abnormalities, not elsewhere classified (Q90-Q99) range of the CMS exempt list.
What is the ICD-9 equivalent of Q95.3?
Under the General Equivalence Mappings, balanced sex/autosomal rearrangement in abnormal individual converts to ICD-9-CM 758.5 (autosomal anomalies NEC). The mapping is approximate, so confirm the match fits the documentation.
Does Q95.3 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage: Q95.3 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).
