Program Operations Manual System (POMS)
   TN 69 (12-23)
   DI 23022.390 Edwards Syndrome (Trisomy 18)
   
   
   
   
      
         
            
            
            
         
         
            
            
               
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                   COMPASSIONATE ALLOWANCES INFORMATION 
                  
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                   EDWARDS
                        SYNDROME (TRISOMY
                        18)
                         
                  
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                   ALTERNATENAMES 
                  
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                   Chromosome 18; Complete Trisomy 18 Syndrome; Trisomy 18; Trisomy 18 Complete; Trisomy
                     E Syndrome
                   
                  
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                   DESCRIPTION 
                  
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                   Edwards syndrome is a genetic disorder in which a person has an extra third copy (trisomy) of genetic
                     material from chromosome 18, instead of the usual two copies. This chromosomal condition
                     causes severe intellectual disability and congenital abnormalities. It severely affects
                     all organ systems of the body. Children born with Edwards syndrome often have intellectual
                     disability and delayed development, congenital heart disease, seizures, and physical
                     malformations. Associated conditions may include heart defects such as ventricular
                     septal defect and malformations of the digestive tract, urinary tract, and genitals.
                     Due to the presence of several life-threatening medical problems, many infants die
                     within their first month. This disorder is a relatively common syndrome affecting
                     approximately 1 out of 3,000 live births. It is three times more common in girls than
                     boys.
                   
                  
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                   DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
                        ICD-9-CM/ICD-10-CM
                        CODING 
                  
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                   Diagnostic testing: The diagnosis of Edwards syndrome is made by genetic testing of the amniotic fluid;
                     ultrasounds of the heart and abdomen; and x-rays of the skeletal system.
                   
                  
                  Physical findings: Individuals with Edwards syndrome are characterized by:
                   
                  
                  
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                              Clenched hands with second and fifth fingers on top of the others; 
                              
                            
                         
                      
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                              Other defects of the hands and feet; 
                              
                            
                         
                      
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                              Underdeveloped finger nails; and 
                              
                            
                         
                      
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                  ICD-9:758.2
                   
                  
                  ICD-10: Q91.3
                   
                  
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                   PROGRESSION 
                  
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                   Fifty percent of infants with this condition do not survive beyond the first week
                     of life. Some children have survived to teenage years, but with serious medical and
                     developmental problems.
                   
                  
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                   TREATMENT 
                  
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                   Treatment of Edwards syndrome consists of symptomatic and supportive care. Treatment
                     is dependent on the medical condition of the individual and the affected organ defects.
                   
                  
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                   SUGGESTED
                        PROGRAMMATIC
                        ASSESSMENT* 
                  
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                   Suggested MER for
                        Evaluation: 
                  
                  
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                              Clinical history and examination that describes the diagnostic features of the impairment;
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                              Laboratory tests showing results of chorionic villus sampling (CVS). 
                              
                            
                         
                      
                   
                  
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                   Suggested Listings for Evaluation: 
                  
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                   DETERMINATION 
                  
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                   LISTING 
                  
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                   REMARKS 
                  
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                   Meets 
                  
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                   110.08 A 
                  
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                   Equals 
                  
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                   *Adjudicators may, at their discretion, use the Medical Evidence of Record or the
                     listings suggested to evaluate the claim. However, the decision to allow or deny the
                     claim rests with the adjudicator.
                   
                  
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