I · MMTA - Endocrine
One of the twelve PDGM clinical groups. CMS maps 426 ICD-10-CM codes to it in grouper v07.2.26.
Group I
ICD-10-CM codes
426
Across 8 ICD-10-CM ranges, in grouper v07.2.26.
Functional bands
≤27 · 28–41 · 42+
OASIS points for low, medium and high functional impairment in this group.
LUPA thresholds
3 to 5 visits
Across the group’s 36 case-mix codes. Fewer visits than the threshold pays per visit.
Every HIPPS code in group I, with its LUPA threshold
1 · Community, Early
2 · Institutional, Early
3 · Community, Late
ICD-10-CM ranges that feed this group
- E08-E13Diabetes mellitus280
- E20-E35Disorders of other endocrine glands64
- E00-E07Disorders of thyroid gland46
- E70-E88Metabolic disorders15
- E15-E16Other disorders of glucose regulation and pancreatic internal secretion9
- E89-E89Postprocedural endocrine and metabolic complications and disorders, not elsewhere classified8
- E40-E46Malnutrition3
- E36-E36Intraoperative complications of endocrine system1
What lands a period in this group
The clinical group is set by the principal diagnosis on the claim, and it is one of the five things that decide a 30-day period’s case-mix group, alongside admission source, timing, functional impairment level and comorbidity adjustment. CMS maps 426 ICD-10-CM codes to MMTA - Endocrine, spread across 8 ICD-10-CM ranges.
Those ranges are not always the ones you would expect from the chapter. Cerebrovascular disease sits in the circulatory chapter alongside heart failure, but CMS groups strokes as neurological rehabilitation, which is why the chapter a code lives in is a poor guide to how it pays.
The other eleven groups
- AMMTA - Other
- BNeuro Rehabilitation
- CWound
- DComplex Nursing Interventions
- EMusculoskeletal Rehabilitation
- FBehavioral Health
- GMMTA - Surgical Aftercare
- HMMTA - Cardiac and Circulatory
- JMMTA - Gastrointestinal tract and Genitourinary system
- KMMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases
- LMMTA - Respiratory
Source: CMS HH PPS Grouper Software v07.2.26 for the codes and bands, read from the CMS table, not transcribed; CMS’s CY2026 case-mix weights and LUPA thresholds file for the thresholds. Not certified, endorsed or approved by CMS.
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