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    OpenPayerBilling CodesOther congenital malformationsICD-10-CM q86-congenital-malformation-syndromes
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    ICD-10-CM Code For Congenital Malformation Syndromes Due To Known Exogenous Causes: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group Q86 includes congenital malformation syndromes due to known exogenous causes and not elsewhere classified, such as fetal alcohol spectrum disorders and other teratogenic exposures that lead to multisystem anomalies. These ICD-10-CM diagnosis codes are used to document patients with congenital anomalies arising from specified external causes, capturing the extent of organ involvement and developmental impact. Accurate coding within the ICD-10-CM Q86 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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    ICD-10-CM Q86: Congenital Malformation Syndromes Due To Known Exogenous Causes, Not Elsewhere Classified Overview

    This group represents congenital malformation syndromes caused by identified external exposures that produce multiple structural anomalies present at birth, often affecting multiple organ systems. These conditions target embryologic development and commonly involve the central nervous system, craniofacial structures, limbs, and internal organs. Accurate coding is important to reflect clinical complexity and to ensure appropriate claim processing and reimbursement.

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    When to Use

    Use a code from this group when documentation identifies a congenital malformation syndrome and links it to a known external cause or teratogenic exposure, and no more specific category applies. These codes apply for reporting diagnoses in newborns or patients with congenital anomalies attributable to documented exogenous agents.

    ICD-10-CM Codes

    4 rows

    ICD-10-CM CodeDescription
    Q86.0Fetal alcohol syndrome (dysmorphic)
    Q86.1Fetal hydantoin syndrome
    Q86.2Dysmorphism due to warfarin
    Q86.8Other congenital malformation syndromes due to known exogenous causes

    DRG Codes

    1 rows

    DRG CodeDescription
    794Neonate with Other Significant Problems

    Typical Clinical Scenarios

    • A term newborn is evaluated in the neonatal unit for multiple dysmorphic features including microcephaly, facial clefting, limb contractures, and skin scarring after documented in utero exposure to misoprostol reported by the mother. The infant requires multidisciplinary assessments (neonatology, genetics, and orthopedics) and the team assigns a diagnosis reflecting a congenital malformation syndrome known to be caused by an exogenous agent. Typical codes: Q86.0
    • A school-age child with a history of prenatal exposure to anticonvulsant medication presents to pediatrics with developmental delay, growth deficiency, and characteristic facial and skeletal anomalies; the child is followed longitudinally for developmental therapy and orthopedic monitoring. Because the constellation of anomalies is attributable to a known teratogenic exposure and does not fit a single organ-specific code, a congenital malformation syndrome due to a known exogenous cause is coded. Typical codes: Q86.1, Q86.2
    • An adolescent with previous documentation of congenital limb hypoplasia and ear malformations from prenatal vascular disruption is seen for surgical planning of prosthetic fitting and auditory rehabilitation; current care documents the congenital malformations as ongoing comorbid conditions affecting treatment choices. A code from this group is used to capture the underlying congenital malformation syndrome caused by an external prenatal event as a comorbidity impacting care. Typical codes: Q86.8

    Related Codes

    Q80-CONGENITAL-ICHTHYOSIS

    ICD-10-CM Code For Congenital Ichthyosis: Group Overview

    Q81-EPIDERMOLYSIS-BULLOSA

    ICD-10-CM Code For Epidermolysis Bullosa: Group Overview

    Q82-OTHER-CONGENITAL-MALFORMATIONS-OF-SKIN

    ICD-10-CM Code For Other Congenital Malformations Of Skin: Group Overview

    Q84-OTHER-CONGENITAL-MALFORMATIONS-OF-INTEGUMENT

    ICD-10-CM Code For Other Congenital Malformations Of Integument: Group Overview

    Q85-PHAKOMATOSES-NOT-ELSEWHERE-CLASSIFIED

    ICD-10-CM Code For Phakomatoses Not Elsewhere Classified: Group Overview

    Q87-OTHER-SPECIFIED-CONGENITAL-MALFORMATION-SYNDROMES

    ICD-10-CM Code For Other Specified Congenital Malformation Syndromes Affecting Multiple Systems: Group Overview

    Q89-OTHER-CONGENITAL-MALFORMATIONS

    ICD-10-CM Code For Other Congenital Malformations Not Elsewhere Classified: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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