What is ICD-10 code D80.1?

D80.1 is the ICD-10-CM diagnosis code for Nonfamilial hypogammaglobulinemia. A condition where the body produces abnormally low levels of antibodies that is not inherited or familial. D80.1 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D80.1 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. D80.1 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. D80.1 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for D80.1?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. D80.1 was a payment HCC under V24 (Disorders of Immunity) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting D80.1?

Use this code when hypogammaglobulinemia is acquired rather than genetic Document the underlying cause if known (e.g., medication-related, secondary to other disease) Because D80.1 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

D80.1: Nonfamilial hypogammaglobulinemia — ICD-10

ICD-10-CM Code View

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Code lookupD80.1Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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)

D80.1

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Nonfamilial hypogammaglobulinemia

A condition where the body produces abnormally low levels of antibodies that is not inherited or familial.

Buddy Insight

Nonfamilial hypogammaglobulinemia is an acquired form of antibody deficiency where immunoglobulin levels are abnormally low without a hereditary or genetic basis.

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Mapped

HCC 47

Disorders of Immunity

RAF 0.472

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 47

Disorders of Immunity

RAF 0.0

RXHCC

Mapped

HCC 99

Immunodeficiencies

RAF 0.0

Code Trumping

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Code Book Path

Official

D80Immunodeficiency with predominantly antibody defects

D80.1Nonfamilial hypogammaglobulinemia

Inclusion Terms

Official

Agammaglobulinemia with immunoglobulin-bearing B-lymphocytes
Common variable agammaglobulinemia [CVAgamma]
Hypogammaglobulinemia NOS

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D80.1 in this effective period.

Related Child Codes

Official

D80.0Hereditary hypogammaglobulinemia

D80.2Selective deficiency of immunoglobulin A [IgA]

D80.3Selective deficiency of immunoglobulin G [IgG] subclasses

D80.4Selective deficiency of immunoglobulin M [IgM]

D80.5Immunodeficiency with increased immunoglobulin M [IgM]

Includes

Official

ICD-10-CM does not list Includes notes for D80.1 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D80.1 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D80.1 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D80.1 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D80.1 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation should include quantitative immunoglobulin levels demonstrating low Immunoglobulin G (and potentially Immunoglobulin A and Immunoglobulin M), absence of family history suggesting hereditary cause, potential causative factors (medications, underlying disease), frequency and types of infections, and current treatment including immunoglobulin replacement dosing and schedule.

Document that the condition is acquired, not inherited.

MEAT Support

HCC Buddy guidance

Document that the condition is acquired, not inherited.

Audit Caution

HCC Buddy guidance

Do not assign this code when hypogammaglobulinemia results from a specific drug

consider D84.821 (immunodeficiency due to drugs) as an additional code. Avoid defaulting to D80.1 when common variable immunodeficiency criteria are met, as the D83 series is more appropriate and equally specific. Ensure documentation explicitly states or implies acquired rather than genetic etiology.

Common Mistakes

HCC Buddy guidance

D80.0 (hereditary hypogammaglobulinemia, which requires genetic/familial etiology), D83.9 (common variable immunodeficiency, a distinct diagnostic entity with specific criteria), D80.9 (unspecified antibody deficiency when the nonfamilial nature is not documented), D89.9 (unspecified immune disorder, far less specific).

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is D80.1 an HCC code?

Yes. D80.1 maps to Disorders of Immunity under the V24 model but is not retained in V28.

HCC Category Mapping

V24HCC 47, Disorders of Immunity

0.472

ESRDHCC 47, Disorders of Immunity

0.000

RxHCCHCC 99, Immunodeficiencies

0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for D80.1

For D80.1to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

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

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed D80.1 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

D80.1 is the ICD-10-CM diagnosis code for nonfamilial hypogammaglobulinemia. A condition where the body produces abnormally low levels of antibodies that is not inherited or familial. D80.1 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 older CMS-HCC V24 model, D80.1 maps to Disorders of Immunity (HCC 47) with a community, non-dual, aged base RAF weight of 0.472. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Use this code when hypogammaglobulinemia is acquired rather than genetic. Because D80.1 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, and MEAT documentation criteria for D80.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code when hypogammaglobulinemia is acquired rather than genetic
•Document the underlying cause if known (e.g., medication-related, secondary to other disease)

Clinical Significance

Nonfamilial hypogammaglobulinemia is an acquired form of antibody deficiency where immunoglobulin levels are abnormally low without a hereditary or genetic basis. This condition may result from medications, protein-losing conditions, or unknown causes, and predisposes patients to recurrent sinopulmonary and gastrointestinal infections requiring immunoglobulin replacement therapy.

Documentation Requirements

✓Documentation should include quantitative immunoglobulin levels demonstrating low Immunoglobulin G (and potentially Immunoglobulin A and Immunoglobulin M), absence of family history suggesting hereditary cause, potential causative factors (medications, underlying disease), frequency and types of infections, and current treatment including immunoglobulin replacement dosing and schedule.
✓Document that the condition is acquired, not inherited.

Commonly Confused Codes

•D80.0 (hereditary hypogammaglobulinemia, which requires genetic/familial etiology), D83.9 (common variable immunodeficiency, a distinct diagnostic entity with specific criteria), D80.9 (unspecified antibody deficiency when the nonfamilial nature is not documented), D89.9 (unspecified immune disorder, far less specific).