ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 E23.0

Billable / Specific HCC v28: 23 CC

Hypopituitarism

E23
Block
15
Synonyms
172
LCDs
17
Payer Policies
20
Linked CPTs

About ICD-10-CM E23.0

ICD-10-CM code E23.0 represents Hypopituitarism. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E23). The 2026 edition of ICD-10-CM E23.0 became effective on October 1, 2025.

Coding Tips for E23.0

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

E23.0 is a CMS-HCC v28 risk-adjustment code (category 23). 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.

Inpatient DRG impact: CC

E23.0 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.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under E23.0. Per CMS ICD-10-CM Tabular 2026.

  • Fertile eunuch syndrome
  • Hypogonadotropic hypogonadism
  • Idiopathic growth hormone deficiency
  • Isolated deficiency of gonadotropin
  • Isolated deficiency of growth hormone
  • Isolated deficiency of pituitary hormone
  • Kallmann's syndrome
  • Lorain-Levi short stature
  • Necrosis of pituitary gland (postpartum)
  • Panhypopituitarism
  • Pituitary cachexia
  • Pituitary insufficiency NOS
  • Pituitary short stature
  • Sheehan's syndrome
  • Simmonds' disease

Use Additional Code

When coding E23.0, also report these additional codes when applicable.

  • code, if applicable, for associated cachexia (E88.A)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 23
ESRD-HCC
Category 23
RxHCC (Part D)
Category 23

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 Hypopituitarism. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for E23.0

Local Coverage Determinations (LCDs) from CMS MACs that list E23.0 as a covered diagnosis.

172 LCDs

Showing top 10 of 172 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Visual Fields Testing
Article ID: 56551, Effective: 2025-10-01 00:00:00, 1427 covered, 0 non-covered
CPT 92082 →
CMS LCD: Billing and Coding: Visual Fields Testing
Article ID: 56551, Effective: 2025-10-01 00:00:00, 1427 covered, 0 non-covered
CPT 92083 →
CMS LCD: Billing and Coding: Visual Fields Testing
Article ID: 56551, Effective: 2025-10-01 00:00:00, 1427 covered, 0 non-covered
CPT 92081 →
CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone
Article ID: 58828, Effective: 2026-04-02 00:00:00, 39 covered, 0 non-covered
CPT J1071 →
CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone
Article ID: 58828, Effective: 2026-04-02 00:00:00, 39 covered, 0 non-covered
CPT J3145 →
CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone
Article ID: 58828, Effective: 2026-04-02 00:00:00, 39 covered, 0 non-covered
CPT 84410 →
CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone
Article ID: 58828, Effective: 2026-04-02 00:00:00, 39 covered, 0 non-covered
CPT 84403 →
CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone
Article ID: 58828, Effective: 2026-04-02 00:00:00, 39 covered, 0 non-covered
CPT 11980 →
CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone
Article ID: 58828, Effective: 2026-04-02 00:00:00, 39 covered, 0 non-covered
CPT J3121 →
CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone
Article ID: 58828, Effective: 2026-04-02 00:00:00, 39 covered, 0 non-covered
CPT 96372 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing E23.0.

17 policies

5 Medicare

Billing and Coding: Visual Fields Testing
Policy ID: ART-56551
Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography
Policy ID: ART-56631
Billing and Coding: Visual Fields Testing
Policy ID: ART-56799
Billing and Coding: Aortography and Peripheral Angiography
Policy ID: ART-57056

5 Aetna

Genetic Testing
Policy ID: CPB-0140
Growth Hormone (GH) and Growth Hormone Antagonists
Policy ID: CPB-0170
Infertility
Policy ID: CPB-0327
Implantable Hormone Pellets
Policy ID: CPB-0345
Progestins
Policy ID: CPB-0510

CPT Codes Commonly Billed with E23.0

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

20 linkages
  • J3145 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • 84403 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • 84410 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • J1072 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • 11980 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • J1071 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • J3121 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • 77081 CMS LCD: Billing and Coding: Bone Mass Measurement CMS LCD
  • 0556T CMS LCD: Billing and Coding: Bone Mass Measurement CMS LCD
  • 78350 CMS LCD: Billing and Coding: Bone Mass Measurement CMS LCD

Convert E23.0 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
E23.0 2532 10000
E23.0 2533 10000
E23.0 6281 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 E23.0, Billing FAQ

Is ICD-10 code E23.0 billable? +

Yes, E23.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to E23.0? +

ICD-10 E23.0 includes: Fertile eunuch syndrome; Hypogonadotropic hypogonadism; Idiopathic growth hormone deficiency, and 12 more clinical synonyms.

Does E23.0 affect Medicare Advantage HCC risk adjustment? +

Yes. E23.0 maps to CMS-HCC v28 category 23. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is E23.0 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 E23.0? +

Procedures frequently paired with E23.0 include: J3145, 84403, 84410, J1072, 11980.

What ICD-9 codes does E23.0 map to? +

Per CMS GEMs, E23.0 maps to ICD-9 codes: 2532, 2533, 6281. Useful for legacy data review and historical claim analysis.

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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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