ICD-10 Q97
Non-Billable HeaderOther sex chromosome abnormalities, female phenotype, not elsewhere classified
About ICD-10-CM Q97
ICD-10-CM code Q97 represents Other sex chromosome abnormalities, female phenotype, not elsewhere classified. This is a non-billable header code in the Congenital Malformations chapter (block Q97). The 2026 edition of ICD-10-CM Q97 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with Q97. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- Turner's syndrome (Q96.-)
Medicare LCD Coverage for Q97
Local Coverage Determinations (LCDs) from CMS MACs that list Q97 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Q97.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Q97 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Q97
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To Q97
Other codes in section Q90-Q99 (Chromosomal abnormalities, not elsewhere classified).
ICD-10 Q97, Billing FAQ
Is ICD-10 code Q97 billable? +
No, Q97 is a non-billable header code. Use a more specific child code from block Q97 when submitting claims.
What codes are Type 1 Excludes for Q97? +
Type 1 Excludes (never code together with Q97): Turner's syndrome (Q96.-)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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