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

ICD-10 E34.4

Billable / Specific HCC v28: 23

Constitutional tall stature

E34
Block
1
Synonyms
130
LCDs
7
Payer Policies
0
Linked CPTs

About ICD-10-CM E34.4

ICD-10-CM code E34.4 represents Constitutional tall stature. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E34). The 2026 edition of ICD-10-CM E34.4 became effective on October 1, 2025.

Coding Tips for E34.4

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

HCC capture: document with MEAT each year

E34.4 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 E34.4. Per CMS ICD-10-CM Tabular 2026.

  • Constitutional gigantism

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 E34.4

Local Coverage Determinations (LCDs) from CMS MACs that list E34.4 as a covered diagnosis.

130 LCDs

Showing top 10 of 130 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: CT of the Head
Article ID: 56612, Effective: 2025-10-01 00:00:00, 7586 covered, 0 non-covered
CPT G2187 →
CMS LCD: Billing and Coding: CT of the Head
Article ID: 56612, Effective: 2025-10-01 00:00:00, 7586 covered, 0 non-covered
CPT G2188 →
CMS LCD: Billing and Coding: CT of the Head
Article ID: 56612, Effective: 2025-10-01 00:00:00, 7586 covered, 0 non-covered
CPT G2195 →
CMS LCD: Billing and Coding: CT of the Head
Article ID: 56612, Effective: 2025-10-01 00:00:00, 7586 covered, 0 non-covered
CPT G2189 →
CMS LCD: Billing and Coding: CT of the Head
Article ID: 56612, Effective: 2025-10-01 00:00:00, 7586 covered, 0 non-covered
CPT G2194 →
CMS LCD: Billing and Coding: CT of the Head
Article ID: 56612, Effective: 2025-10-01 00:00:00, 7586 covered, 0 non-covered
CPT G2193 →
CMS LCD: Billing and Coding: CT of the Head
Article ID: 56612, Effective: 2025-10-01 00:00:00, 7586 covered, 0 non-covered
CPT G2192 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing E34.4.

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: 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

CPT Codes Commonly Billed with E34.4

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

No procedure linkages on file for E34.4

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert E34.4 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
E34.4 2530 10000

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

ICD-10 E34.4, Billing FAQ

Is ICD-10 code E34.4 billable? +

Yes, E34.4 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 E34.4? +

ICD-10 E34.4 includes: Constitutional gigantism.

Does E34.4 affect Medicare Advantage HCC risk adjustment? +

Yes. E34.4 maps to CMS-HCC v28 category 23. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does E34.4 map to? +

Per CMS GEMs, E34.4 maps to ICD-9 codes: 2530. 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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