ICD-10 E23.1
Billable / Specific HCC v28: 23Drug-induced hypopituitarism
About ICD-10-CM E23.1
ICD-10-CM code E23.1 represents Drug-induced hypopituitarism. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E23). The 2026 edition of ICD-10-CM E23.1 became effective on October 1, 2025.
Coding Tips for E23.1
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E23.1 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.
Use Additional Code
When coding E23.1, also report these additional codes when applicable.
- code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
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.
Medicare LCD Coverage for E23.1
Local Coverage Determinations (LCDs) from CMS MACs that list E23.1 as a covered diagnosis.
Showing top 10 of 146 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E23.1.
5 Medicare
1 Aetna
CPT Codes Commonly Billed with E23.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 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
Convert E23.1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| E23.1 | 2537 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E23.1
Other codes in section E20-E35 (Disorders of other endocrine glands).
ICD-10 E23.1, Billing FAQ
Is ICD-10 code E23.1 billable? +
Yes, E23.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does E23.1 affect Medicare Advantage HCC risk adjustment? +
Yes. E23.1 maps to CMS-HCC v28 category 23. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with E23.1? +
Procedures frequently paired with E23.1 include: J3145, 84403, 84410, J1072, 11980.
What ICD-9 codes does E23.1 map to? +
Per CMS GEMs, E23.1 maps to ICD-9 codes: 2537. 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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