ICD-10 E74.04
Billable / Specific HCC v28: 23 CCMcArdle disease
About ICD-10-CM E74.04
ICD-10-CM code E74.04 represents McArdle disease. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E74). The 2026 edition of ICD-10-CM E74.04 became effective on October 1, 2025.
Coding Tips for E74.04
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E74.04 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.
E74.04 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 E74.04. Per CMS ICD-10-CM Tabular 2026.
- Type V glycogen storage disease
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.
Inpatient DRG Impact, CC
codes McArdle disease. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for E74.04
Local Coverage Determinations (LCDs) from CMS MACs that list E74.04 as a covered diagnosis.
Showing top 10 of 204 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E74.04.
1 Cigna
5 Medicare
1 Aetna
CPT Codes Commonly Billed with E74.04
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 93456 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
- 93463 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
- 93457 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
- G0269 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
- 93593 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
- 93564 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
- 75705 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
- 75716 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
- 93505 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
- 93568 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
Convert E74.04 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 |
|---|---|---|
| E74.04 | 2710 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E74.04
Other codes in section E70-E88 (Metabolic disorders).
ICD-10 E74.04, Billing FAQ
Is ICD-10 code E74.04 billable? +
Yes, E74.04 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 E74.04? +
ICD-10 E74.04 includes: Type V glycogen storage disease.
Does E74.04 affect Medicare Advantage HCC risk adjustment? +
Yes. E74.04 maps to CMS-HCC v28 category 23. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is E74.04 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 CPT codes are commonly billed with E74.04? +
Procedures frequently paired with E74.04 include: 93456, 93463, 93457, G0269, 93593.
What ICD-9 codes does E74.04 map to? +
Per CMS GEMs, E74.04 maps to ICD-9 codes: 2710. 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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