D72.12 ICD-10-CM Code: Drug rash with eosinophilia and systemic symptoms syndrome
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) / Other disorders of blood and blood-forming organs (D70-D77)
D72.12
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDrug rash with eosinophilia and systemic symptoms syndrome
A serious drug reaction characterized by rash, fever, and elevated eosinophils that affects multiple organ systems.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- DRESS syndrome
Excludes 2
Official- Löffler's syndrome (J82.89)
- pulmonary eosinophilia (J82.-)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D72.12 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for D72.12 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D72.12 in this effective period.
Use Additional
Official- code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
Code Also
OfficialICD-10-CM does not list Code Also instructions for D72.12 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is D72.12 an HCC code?
No. D72.12 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- D72.12
- Description
- Drug rash with eosinophilia and systemic symptoms syndrome
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
D72.12 is the ICD-10-CM diagnosis code for drug rash with eosinophilia and systemic symptoms syndrome. A serious drug reaction characterized by rash, fever, and elevated eosinophils that affects multiple organ systems. D72.12 sits in the ICD-10-CM chapter for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (d50-d89), within the section covering other disorders of blood and blood-forming organs (d70-d77).
D72.12 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Always link this code with the causative drug using an external cause code (T36-T50 series).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D72.12 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.