MCMCB Pro
E75.242

E75.242Niemann-Pick disease type C

Billable / specific codeICD-10-CM

E75.242 is a billable, specific ICD-10-CM code for niemann-pick disease type c. It is valid for submission on a claim.

Other codes that can never be billed with E75.242

These codes carry an Excludes1 note pointing at E75.242. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading E75.242 alone.

  • E78.7Disorders of bile acid and cholesterol metabolism

Risk adjustment

E75.242 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

E75.242 is named in 13 Medicare coverage policies 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

  • A52996Billing and Coding: Routine Foot Care
  • A56232Billing and Coding: Foot Care
  • A56943Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment
  • A57037Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment

How E75.242 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 E75.242.

  • Niemann-Pick disease or syndrometypeC

Related codes at this level

Codes that share E75.24. If E75.242 is not quite right, the correct code is usually one of these.

Questions about E75.242

Is E75.242 a billable ICD-10-CM code?
Yes. E75.242 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does E75.242 sit in the tabular list?
Endocrine, nutritional and metabolic diseases (E00-E89), in the block Metabolic disorders (E70-E88).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.