ICD-10 E23.6
Billable / Specific HCC v28: 23Other disorders of pituitary gland
About ICD-10-CM E23.6
ICD-10-CM code E23.6 represents Other disorders of pituitary gland. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E23). The 2026 edition of ICD-10-CM E23.6 became effective on October 1, 2025.
Coding Tips for E23.6
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E23.6 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under E23.6. Per CMS ICD-10-CM Tabular 2026.
- Abscess of pituitary
- Adiposogenital dystrophy
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 E23.6
Local Coverage Determinations (LCDs) from CMS MACs that list E23.6 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 E23.6.
5 Medicare
1 Aetna
CPT Codes Commonly Billed with E23.6
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 E23.6 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 |
|---|---|---|
| E23.6 | 2538 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E23.6
Other codes in section E20-E35 (Disorders of other endocrine glands).
ICD-10 E23.6, Billing FAQ
Is ICD-10 code E23.6 billable? +
Yes, E23.6 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 E23.6? +
ICD-10 E23.6 includes: Abscess of pituitary; Adiposogenital dystrophy.
Does E23.6 affect Medicare Advantage HCC risk adjustment? +
Yes. E23.6 maps to CMS-HCC v28 category 23. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with E23.6? +
Procedures frequently paired with E23.6 include: J3145, 84403, 84410, J1072, 11980.
What ICD-9 codes does E23.6 map to? +
Per CMS GEMs, E23.6 maps to ICD-9 codes: 2538. 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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