ICD-10 E55.0
Billable / Specific CCRickets, active
About ICD-10-CM E55.0
ICD-10-CM code E55.0 represents Rickets, active. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E55). The 2026 edition of ICD-10-CM E55.0 became effective on October 1, 2025.
Coding Tips for E55.0
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E55.0 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 E55.0. Per CMS ICD-10-CM Tabular 2026.
- Infantile osteomalacia
- Juvenile osteomalacia
Type 1 Excludes
Pure excludes, these codes can never be coded together with E55.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- celiac rickets (K90.0)
- Crohn's rickets (K50.-)
- hereditary vitamin D-dependent rickets (E83.32)
- inactive rickets (E64.3)
- renal rickets (N25.0)
- sequelae of rickets (E64.3)
- vitamin D-resistant rickets (E83.31)
Inpatient DRG Impact, CC
codes Rickets, active. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for E55.0
Local Coverage Determinations (LCDs) from CMS MACs that list E55.0 as a covered diagnosis.
Showing top 10 of 20 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E55.0.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with E55.0
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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 E55.0 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 |
|---|---|---|
| E55.0 | 2680 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E55.0
Other codes in section E50-E64 (Other nutritional deficiencies).
ICD-10 E55.0, Billing FAQ
Is ICD-10 code E55.0 billable? +
Yes, E55.0 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 E55.0? +
ICD-10 E55.0 includes: Infantile osteomalacia; Juvenile osteomalacia.
What codes are Type 1 Excludes for E55.0? +
Type 1 Excludes (never code together with E55.0): celiac rickets (K90.0); Crohn's rickets (K50.-); hereditary vitamin D-dependent rickets (E83.32)
Is E55.0 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 ICD-9 codes does E55.0 map to? +
Per CMS GEMs, E55.0 maps to ICD-9 codes: 2680. 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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