ICD-10 E75.22
Billable / Specific HCC v28: 23Gaucher disease
About ICD-10-CM E75.22
ICD-10-CM code E75.22 represents Gaucher disease. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E75). The 2026 edition of ICD-10-CM E75.22 became effective on October 1, 2025.
Coding Tips for E75.22
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E75.22 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
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 E75.22
Local Coverage Determinations (LCDs) from CMS MACs that list E75.22 as a covered diagnosis.
Showing top 10 of 215 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E75.22.
1 Cigna
5 Medicare
3 Aetna
CPT Codes Commonly Billed with E75.22
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 83090 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
- 83700 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
- 82172 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
- 86141 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
- 83701 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
- 83719 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
- 83721 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
- 83698 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
- 83695 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
- 83704 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
Convert E75.22 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 |
|---|---|---|
| E75.22 | 2727 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E75.22
Other codes in section E70-E88 (Metabolic disorders).
ICD-10 E75.22, Billing FAQ
Is ICD-10 code E75.22 billable? +
Yes, E75.22 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does E75.22 affect Medicare Advantage HCC risk adjustment? +
Yes. E75.22 maps to CMS-HCC v28 category 23. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with E75.22? +
Procedures frequently paired with E75.22 include: 83090, 83700, 82172, 86141, 83701.
What ICD-9 codes does E75.22 map to? +
Per CMS GEMs, E75.22 maps to ICD-9 codes: 2727. 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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