D80.6
BillableAntibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D80.6 an HCC code?
Yes. D80.6 maps to Disorders of Immunity under the V24 model but is not retained in V28.
HCC Category Mapping
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 D80.6
For D80.6to 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 D80.6 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D80.6 is the ICD-10-CM diagnosis code for antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia. A condition where the body has difficulty producing effective antibodies despite having normal or elevated immunoglobulin levels, resulting in weakened immune response. D80.6 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, D80.6 maps to Disorders of Immunity (HCC 47) with a community, non-dual, aged base RAF weight of 0.665. 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.
Verify documentation specifies near-normal immunoglobulins or hyperimmunoglobulinemia to distinguish from other antibody deficiencies. Because D80.6 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 D80.6 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies near-normal immunoglobulins or hyperimmunoglobulinemia to distinguish from other antibody deficiencies
- •Review lab results showing immunoglobulin levels to support medical necessity
Clinical Significance
Antibody deficiency with near-normal immunoglobulins or hyperimmunoglobulinemia represents a functional immunodeficiency where patients fail to mount adequate antibody responses to infections and vaccines despite having normal or elevated quantitative immunoglobulin levels. This condition highlights that immunoglobulin quantity alone does not guarantee immune competence, as antibody quality and specificity may be impaired.
Documentation Requirements
- ✓Documentation must include quantitative immunoglobulin levels showing normal or elevated values, evidence of functional antibody deficiency through poor response to vaccine challenge testing (pneumococcal or tetanus titers post-vaccination), recurrent infection history despite normal immunoglobulin levels, and treatment plan. Specific antibody titers pre
- ✓and post-vaccination should be documented.
Commonly Confused Codes
- •D80.1 (nonfamilial hypogammaglobulinemia where immunoglobulin levels are quantitatively low), D80.9 (unspecified antibody deficiency), D83.9 (common variable immunodeficiency which typically has low immunoglobulins), D84.9 (immunodeficiency, unspecified, which lacks specificity about the antibody-related nature).