E74.4 — Disorders of pyruvate metabolism and gluconeogenesis
E74.4 is a billable, specific ICD-10-CM code for disorders of pyruvate metabolism and gluconeogenesis. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Deficiency of phosphoenolpyruvate carboxykinase
- Deficiency of pyruvate carboxylase
- Deficiency of pyruvate dehydrogenase
Other codes that can never be billed with E74.4
These codes carry an Excludes1 note pointing at E74.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading E74.4 alone.
- E88.4Mitochondrial metabolism disorders
Risk adjustment
E74.4 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.
Medicare coverage
E74.4 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
How E74.4 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to E74.4.
- Deficiency, deficient›phosphoenolpyruvate carboxykinase
- Disorder›gluconeogenesis
- Disorder›pyruvate metabolism
- Deficiency, deficient›pyruvate›carboxylase
- Deficiency, deficient›pyruvate›dehydrogenase
- Disorder›metabolism NOS›pyruvate
Related codes at this level
Codes that share E74. If E74.4 is not quite right, the correct code is usually one of these.
Questions about E74.4
- Is E74.4 a billable ICD-10-CM code?
- Yes. E74.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does E74.4 sit in the tabular list?
- Endocrine, nutritional and metabolic diseases (E00-E89), in the block Metabolic disorders (E70-E88).
- What cannot be coded together with E74.4?
- E74.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.