Is E88.81 a billable ICD-10-CM code?

No. E88.81 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does E88.81 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 E88.81?

E88.81 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above E88.81 (E88) and apply to it just the same.

E88.81

E88.81 — Metabolic syndrome and other insulin resistance

Non-billable headerICD-10-CM

E88.81 is a non-billable header ICD-10-CM code for metabolic syndrome and other insulin resistance. It cannot be billed on its own: choose one of the more specific child codes below.

Use additional code

Add a secondary code to capture the detail described below.

codes for associated manifestations, such as:
obesity (E66.-)

Excludes1 inherited from the categories above E88.81

These are not written on E88.81, but they bind it: a note on a category applies to every code beneath it. Billing E88.81 with anything listed here is a denial.

Written on E88 — Other and unspecified metabolic disorders

histiocytosis X (chronic) (C96.6)

Other codes that can never be billed with E88.81

These codes carry an Excludes1 note pointing at E88.81. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading E88.81 alone.

R73.0Abnormal glucose

Risk adjustment

E88.81 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.

Code history

E88.81 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead E88.81

4 child codes. Green means billable.

Related codes at this level

Codes that share E88.8. If E88.81 is not quite right, the correct code is usually one of these.

Questions about E88.81

Is E88.81 a billable ICD-10-CM code?: No. E88.81 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does E88.81 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 E88.81?: E88.81 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above E88.81 (E88) and apply to it just the same.