E24.0 Pituitary Cushing Maps HCC 51. Nearby E24.8 / E24.2 / E24.9 Do Not Map.

If you searched other Cushing, E24.8, or nearby Cushing syndrome leaves next to V28, you are looking at a narrow E24 cluster where only one billable leaf maps under CMS-HCC V28 for payment year 2026, and several nearby leaves do not.

E24.0 (Pituitary-dependent Cushing's disease) is billable. On the live HCC Buddy FY2026 card it maps to CMS-HCC V28 HCC 51, and the PY2026 V28 CSV row is `E240,51.0,,,`. The live HCC 51 hub title is Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders, with a source-labeled community non-dual aged reference coefficient of 0.51 (11 ICD rows). The E24.0 card displays that same CNA reference as 0.510. That is a category reference, not a member RAF total.

Nearby E24 leaves are also billable ICD-10-CM codes, but they do not map in V28. Live cards show verified no payable V28 mapping, and the PY2026 CSV has no row for them:

• E24.8 Other Cushing's syndrome
• E24.2 Drug-induced Cushing's syndrome
• E24.9 Cushing's syndrome, unspecified
• E24.1 Nelson's syndrome
• E24.3 Ectopic ACTH syndrome
• E24.4 Alcohol-induced pseudo-Cushing's syndrome

Billable is not the same as risk-adjusted. Do not invent a V28 map for those leaves. Do not substitute E24.8, E24.2, or E24.9 to force an HCC 51 when the chart does not support pituitary-dependent Cushing's disease.

Other leaves that do map to HCC 51 in the same CSV file (useful contrast in the same HCC 51 bucket, not Cushing substitutes) include E27.1 (Primary adrenocortical insufficiency) and E22.0 (Acromegaly and pituitary gigantism). CSV rows: `E271,51.0,,,`, `E220,51.0,,,`.

This page is the coder-desk walk for the E24.0 / other-Cushing cluster under CMS-HCC V28 for payment year 2026.

Desk table: verified maps (2026-10-01)

HCC 51 coeff ref 0.51 is the live hub community non-dual aged reference (ICD cards show 0.510). Not a member total. Segment coefficients vary.

What E24.0 means on the claim

E24.0 is the pituitary-dependent Cushing's disease leaf. Use it when the chart supports pituitary-dependent Cushing's disease, not when the chart only supports other Cushing, drug-induced Cushing, unspecified Cushing, Nelson's syndrome, ectopic ACTH, or alcohol-induced pseudo-Cushing.

Do not substitute E24.8, E24.2, E24.9, E24.1, E24.3, or E24.4 to force an HCC 51. Those leaves are billable and clinically real when documented, but they have no V28 payment map in the PY2026 CSV.

Do not confuse pituitary-dependent Cushing's disease (E24.0 -> HCC 51) with primary adrenocortical insufficiency (E27.1) or acromegaly (E22.0). Those also map to HCC 51, but they are different conditions and different documentation paths.

Coding paths (documentation-driven)

Pick the path from what the chart actually supports. Do not invent pituitary Cushing, other Cushing, or Addison disease for RAF.

1. Chart supports pituitary-dependent Cushing's disease -> E24.0 -> V28 HCC 51.

2. Chart supports other Cushing's syndrome without a more specific mapped leaf -> E24.8 -> billable, no V28 map.

3. Chart supports drug-induced Cushing's syndrome -> E24.2 -> billable, no V28 map.

4. Chart supports Cushing's syndrome, unspecified -> E24.9 -> billable, no V28 map.

5. Chart supports Nelson's syndrome -> E24.1 -> billable, no V28 map.

6. Chart supports ectopic ACTH syndrome -> E24.3 -> billable, no V28 map.

7. Chart supports alcohol-induced pseudo-Cushing's syndrome -> E24.4 -> billable, no V28 map.

8. Chart supports primary adrenocortical insufficiency -> E27.1 -> HCC 51.

9. Chart supports acromegaly and pituitary gigantism -> E22.0 -> HCC 51.

10. Do not treat billable as risk-adjusted without checking the live card and CSV.

11. Do not invent member RAF totals from the 0.51 / 0.510 references.

MEAT for mapped HCC 51

A mapped E24.0 (or other mapped leaf in this desk) still needs monitoring, evaluation, assessment, or treatment in the eligible encounter year. A problem-list row that says "Cushing's" or "adrenal insufficiency" from a prior year does not carry the HCC forward by itself.

For mapped endocrine HCCs in this desk, the note should support:

• M Monitor: cortisol pattern, symptoms, blood pressure, glucose, electrolytes, medication effects, safety
• E Evaluate: pituitary vs ectopic vs drug-induced vs other path when used, labs, imaging when documented
• A Assess: explicit pituitary-dependent Cushing's disease, primary adrenocortical insufficiency, acromegaly, or the exact E24 leaf supported (not only "Cushing's" when a more specific code is supported)
• T Treat: endocrine therapy plan, steroid management, surgery or radiation follow-up when documented, medication changes for drug-induced patterns when relevant

MEAT is a review mnemonic, not a universal CMS coding rule. Follow the applicable coding, encounter, program, and payer requirements. See MEAT and problem lists.

Audit and query traps

1. Coding E24.8 / E24.2 / E24.9 / E24.1 / E24.3 / E24.4 as if they map to HCC 51 in V28. They do not. No CSV row. Live cards: no payable V28 map.

2. Treating billable E24 siblings as risk-adjusted because E24.0 maps. Map is leaf-specific.

3. Using unspecified E24.9 when the chart supports pituitary-dependent Cushing's disease (E24.0) or another more specific leaf.

4. Forcing E24.0 when the chart only supports other Cushing, drug-induced Cushing, or pseudo-Cushing.

5. Using the 0.51 / 0.510 CNA reference as a member RAF total.

6. Inventing Coding Clinic quotes, competitor CTAs, or PHI examples.

7. Confusing pituitary-dependent Cushing's disease (E24.0) with primary adrenocortical insufficiency (E27.1) or acromegaly (E22.0) even though all three map to HCC 51.

8. Coding a historical "Cushing's" label with no current MEAT in the eligible year.

9. Treating a nearby no-map E24 leaf as interchangeable with E24.0 for RAF.

Related desks and tools

• Live cards: E24.0, E24.8, E24.2, E24.9, E24.1, E24.3, E24.4, E27.1, E22.0
• Hub: HCC 51
• Lookup: ICD-10 to HCC, Encoder
• Evidence habits: MEAT, problem lists

Current as of October 1, 2026. Always confirm the live card and the PY2026 V28 CSV before you lock a map claim.