Is Q86 a billable ICD-10-CM code?

No. Q86 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does Q86 sit in the tabular list?

Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Other congenital malformations (Q80-Q89).

Q86

Q86 — Congenital malformation syndromes due to known exogenous causes, not elsewhere classified

Non-billable headerICD-10-CM

Q86 is a non-billable header ICD-10-CM code for congenital malformation syndromes due to known exogenous causes, not elsewhere classified. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

iodine-deficiency-related hypothyroidism (E00-E02)
nonteratogenic effects of substances transmitted via placenta or breast milk (P04.-)

Other codes that can never be billed with Q86

These codes carry an Excludes1 note pointing at Q86. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Q86 alone.

P04.1Newborn affected by other maternal medication
P04.3Newborn affected by maternal use of alcohol

Risk adjustment

Q86 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead Q86

4 child codes. Green means billable.

Questions about Q86

Is Q86 a billable ICD-10-CM code?: No. Q86 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does Q86 sit in the tabular list?: Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Other congenital malformations (Q80-Q89).