ICD-10 E84.0
Billable / Specific HCC v28: 110 MCCCystic fibrosis with pulmonary manifestations
About ICD-10-CM E84.0
ICD-10-CM code E84.0 represents Cystic fibrosis with pulmonary manifestations. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E84). The 2026 edition of ICD-10-CM E84.0 became effective on October 1, 2025.
Coding Tips for E84.0
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E84.0 is a CMS-HCC v28 risk-adjustment code (category 110). 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.
E84.0 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Use Additional Code
When coding E84.0, also report these additional codes when applicable.
- code to identify any infectious organism present, such as:
- Pseudomonas (B96.5)
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, MCC
codes Cystic fibrosis with pulmonary manifestations. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for E84.0
Local Coverage Determinations (LCDs) from CMS MACs that list E84.0 as a covered diagnosis.
Showing top 10 of 839 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E84.0.
5 Aetna
2 Cigna
5 Medicare
CPT Codes Commonly Billed with E84.0
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 94618 CMS LCD: Billing and Coding: Pulmonary Stress Testing CMS LCD
- 94619 CMS LCD: Billing and Coding: Pulmonary Stress Testing CMS LCD
- 94617 CMS LCD: Billing and Coding: Pulmonary Stress Testing CMS LCD
- 87812 CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing CMS LCD
- 87428 CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing CMS LCD
- 87913 CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing CMS LCD
- 75635 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
- 93503 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
- 36221 CMS LCD: Billing and Coding: Cardiac Catheterization and Coronary Angiography CMS LCD
- 99292 CMS LCD: Billing and Coding: Respiratory Therapy and Oximetry Services CMS LCD
Convert E84.0 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 |
|---|---|---|
| E84.0 | 27702 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E84.0
Other codes in section E70-E88 (Metabolic disorders).
ICD-10 E84.0, Billing FAQ
Is ICD-10 code E84.0 billable? +
Yes, E84.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does E84.0 affect Medicare Advantage HCC risk adjustment? +
Yes. E84.0 maps to CMS-HCC v28 category 110. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is E84.0 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with E84.0? +
Procedures frequently paired with E84.0 include: 94618, 94619, 94617, 87812, 87428.
What ICD-9 codes does E84.0 map to? +
Per CMS GEMs, E84.0 maps to ICD-9 codes: 27702. 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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