D80.0 ICD-10-CM Code: Hereditary hypogammaglobulinemia
D80.0 maps to CMS-HCC V28 115. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools
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) / Certain disorders involving the immune mechanism (D80-D89)
D80.0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceHereditary hypogammaglobulinemia
A genetic condition where the body produces abnormally low levels of antibodies due to inherited factors.
Buddy Insight
Hereditary hypogammaglobulinemia is a genetically determined primary immunodeficiency characterized by inadequate production of immunoglobulins, leaving patients highly susceptible to recurrent bacterial infections, particularly of the respiratory and gastrointestinal tracts.
CMS-HCC V28
MappedHCC 115
Coefficient HCC 115: 0.565 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 074
Code-level coefficient reference
ESRD/PACE
MappedHCC 47
Code-level coefficient reference
RXHCC
MappedHCC 99
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Autosomal recessive agammaglobulinemia (Swiss type)
- X-linked agammaglobulinemia [Bruton] (with growth hormone deficiency)
Excludes 2
Official- autoimmune disease (systemic) NOS (M35.9)Inherited from D50-D89
- certain conditions originating in the perinatal period (P00-P96)Inherited from D50-D89
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from D50-D89
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from D50-D89
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from D50-D89
- human immunodeficiency virus [HIV] disease (B20)Inherited from D50-D89
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from D50-D89
- neoplasms (C00-D49)Inherited from D50-D89
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from D50-D89
Related Codes
Includes
Official- defects in the complement systemInherited from D80-D89
- immunodeficiency disorders, except human immunodeficiency virus [HIV] diseaseInherited from D80-D89
- sarcoidosisInherited from D80-D89
Excludes 1
Official- autoimmune disease (systemic) NOS (M35.9)Inherited from D80-D89
- functional disorders of polymorphonuclear neutrophils (D71-)Inherited from D80-D89
- human immunodeficiency virus [HIV] disease (B20)Inherited from D80-D89
Code First
OfficialNo Code First sequencing instructions are included in this display for D80.0. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for D80.0. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for D80.0. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 D80.0 an HCC code?
Yes. D80.0 (Hereditary hypogammaglobulinemia) maps to HCC 115, Specified Immunodeficiencies and White Blood Cell Disorders under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.565. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: D80.0 is billable and maps to V28 HCC 115, Specified Immunodeficiencies and White Blood Cell Disorders. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- D80.0
- Description
- Hereditary hypogammaglobulinemia
- HCC (V28)
- HCC 115 — Specified Immunodeficiencies and White Blood Cell Disorders
- RAF reference coefficient
- 0.565
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work D80.0 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for D80.0
For D80.0, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Coder workflow notes
Get the V28 mapping + MEAT cheat sheet
One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.
Free PDF. No card. Unsubscribe anytime.
What This Code Means
D80.0 is the ICD-10-CM diagnosis code for hereditary hypogammaglobulinemia. A genetic condition where the body produces abnormally low levels of antibodies due to inherited factors. D80.0 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 certain disorders involving the immune mechanism (d80-d89).
Under the CMS-HCC V28 risk adjustment model, D80.0 maps to Specified Immunodeficiencies and White Blood Cell Disorders (HCC 115) with a source-labeled community, non-dual, aged reference coefficient of 0.565. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
This code indicates a familial or hereditary pattern; confirm family history is documented. For D80.0, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for D80.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code indicates a familial or hereditary pattern; confirm family history is documented
- •Distinguish from acquired hypogammaglobulinemia by verifying genetic/familial etiology
Clinical Significance
Hereditary hypogammaglobulinemia is a genetically determined primary immunodeficiency characterized by inadequate production of immunoglobulins, leaving patients highly susceptible to recurrent bacterial infections, particularly of the respiratory and gastrointestinal tracts. The most common form is X-linked agammaglobulinemia (Bruton disease), which presents in early childhood after maternal antibodies wane.
Documentation Requirements
- ✓Documentation must establish the hereditary/genetic basis through family history or genetic testing, quantitative immunoglobulin levels (Immunoglobulin G, Immunoglobulin A, Immunoglobulin M all significantly reduced), B-cell enumeration (typically absent or severely reduced in Bruton disease), and response to immunoglobulin replacement therapy.
- ✓Include documentation of recurrent infections and their frequency and severity.
Commonly Confused Codes
- •D80.1 (nonfamilial hypogammaglobulinemia, which is acquired rather than inherited), D83.9 (common variable immunodeficiency which has a later onset and different pathophysiology), D80.6 (antibody deficiency with near-normal immunoglobulins which has functional rather than quantitative defects), D80.9 (unspecified antibody deficiency).