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

ICD-10 E23.7

Billable / Specific HCC v28: 23

Disorder of pituitary gland, unspecified

E23
Block
0
Synonyms
109
LCDs
7
Payer Policies
7
Linked CPTs

About ICD-10-CM E23.7

ICD-10-CM code E23.7 represents Disorder of pituitary gland, unspecified. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E23). The 2026 edition of ICD-10-CM E23.7 became effective on October 1, 2025.

Coding Tips for E23.7

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

HCC capture: document with MEAT each year

E23.7 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.

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.

Medicare LCD Coverage for E23.7

Local Coverage Determinations (LCDs) from CMS MACs that list E23.7 as a covered diagnosis.

109 LCDs

Showing top 10 of 109 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 E23.7.

7 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: Visual Fields Testing
Policy ID: ART-56799
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204
Billing and Coding: Monitored Anesthesia Care
Policy ID: ART-57361

CPT Codes Commonly Billed with E23.7

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

7 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

Convert E23.7 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
E23.7 2539 10000

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

ICD-10 E23.7, Billing FAQ

Is ICD-10 code E23.7 billable? +

Yes, E23.7 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does E23.7 affect Medicare Advantage HCC risk adjustment? +

Yes. E23.7 maps to CMS-HCC v28 category 23. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with E23.7? +

Procedures frequently paired with E23.7 include: J3145, 84403, 84410, J1072, 11980.

What ICD-9 codes does E23.7 map to? +

Per CMS GEMs, E23.7 maps to ICD-9 codes: 2539. 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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