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.-)
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 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).