ICD-10 C88.31
Billable / Specific HCC v28: 10 CCImmunoproliferative small intestinal disease, in remission
About ICD-10-CM C88.31
ICD-10-CM code C88.31 represents Immunoproliferative small intestinal disease, in remission. This is a billable/specific code in the chapter (block C88). The 2026 edition of ICD-10-CM C88.31 became effective on October 1, 2025.
Coding Tips for C88.31
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
C88.31 is a CMS-HCC v28 risk-adjustment code (category 10). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
C88.31 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, CC
codes Immunoproliferative small intestinal disease, in remission. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for C88.31
Local Coverage Determinations (LCDs) from CMS MACs that list C88.31 as a covered diagnosis.
Showing top 10 of 422 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing C88.31.
5 Medicare
CPT Codes Commonly Billed with C88.31
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- J0840 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J0850 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- 90371 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- 90375 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J1573 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J1569 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J1459 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J1557 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J1556 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J1560 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
Codes Adjacent To C88.31
Other codes in section C81-C96 (Malignant neoplasms of lymphoid, hematopoietic and related tissue).
ICD-10 C88.31, Billing FAQ
Is ICD-10 code C88.31 billable? +
Yes, C88.31 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does C88.31 affect Medicare Advantage HCC risk adjustment? +
Yes. C88.31 maps to CMS-HCC v28 category 10. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is C88.31 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with C88.31? +
Procedures frequently paired with C88.31 include: J0840, J0850, 90371, 90375, J1573.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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