ICD-10 · PDGM grouping
E88 Other and unspecified metabolic disorders
All 24 codes in the E88 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
24
Can lead a claim
22
Cannot lead a claim
2
What CMS assigns to E88
22 of the 24 codes group to MMTA - Other; 2 are assigned no clinical group. Comorbidity subgroups: 1 toward Obesity, and Disorders of Metabolism and Fluid Balance; 1 toward Other Combined Immunodeficiencies and Malnutrition, includes graft-versus-host-disease; 22 are assigned none. 22 of the 24 can lead a claim. CMS attaches a code-first note to 2 of the 24.
- Obesity, and Disorders of Metabolism and Fluid Balance: counts toward the high comorbidity tier only in an interaction pair.
- Other Combined Immunodeficiencies and Malnutrition, includes graft-versus-host-disease: can award the low comorbidity tier as a secondary diagnosis.
Code first
CMS grouper convention 4, on E88.14. Code first:
- associated AIDS (B20)
CMS grouper convention 12, on E88.A. Code first:
- underlying disease
Every code in E88
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| E88.0 Disorders of plasma-protein metabolism, not elsewhere classified | ||||
| E88.01 | Alpha-1-antitrypsin deficiency | Can lead a claim | A | None |
| E88.02 | Plasminogen deficiency | Can lead a claim | A | None |
| E88.09 | Other disorders of plasma-protein metabolism, not elsewhere classifiedCMS: Oth disorders of plasma-protein metabolism, NEC | Can lead a claim | A | None |
| E88.1 Lipodystrophy, not elsewhere classified | ||||
| E88.10 | Lipodystrophy, unspecified | Can lead a claim | A | None |
| E88.11 | Partial lipodystrophy | Can lead a claim | A | None |
| E88.12 | Generalized lipodystrophy | Can lead a claim | A | None |
| E88.13 | Localized lipodystrophy | Can lead a claim | A | None |
| E88.14 | HIV-associated lipodystrophy | Can lead a claim, code first applies | A | None |
| E88.19 | Other lipodystrophy, not elsewhere classified | Can lead a claim | A | None |
| E88.2 | Lipomatosis, not elsewhere classified | Can lead a claim | A | None |
| E88.3 | Tumor lysis syndrome | Can lead a claim | A | None |
| E88.4 Mitochondrial metabolism disorders | ||||
| E88.40 | Mitochondrial metabolism disorder, unspecified | Can lead a claim | A | None |
| E88.41 | MELAS syndrome | Can lead a claim | A | None |
| E88.42 | MERRF syndrome | Can lead a claim | A | None |
| E88.43 | Disorders of mitochondrial tRNA synthetases | Can lead a claim | A | None |
| E88.49 | Other mitochondrial metabolism disorders | Can lead a claim | A | None |
| E88.8 Other specified metabolic disorders | ||||
| E88.81 Metabolic syndrome and other insulin resistance | ||||
| E88.810 | Metabolic syndrome | Can lead a claim | A | None |
| E88.811 | Insulin resistance syndrome, Type A | Can lead a claim | A | None |
| E88.818 | Other insulin resistance | Can lead a claim | A | None |
| E88.819 | Insulin resistance, unspecified | Can lead a claim | A | None |
| E88.82 | Obesity due to disruption of MC4R pathway | Can lead a claim | A | Obesity, and Disorders of Metabolism and Fluid Balance |
| E88.89 | Other specified metabolic disorders | Can lead a claim | A | None |
| E88.9 | Metabolic disorder, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| E88.A | Wasting disease (syndrome) due to underlying condition | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | Other Combined Immunodeficiencies and Malnutrition, includes graft-versus-host-disease |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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