D82.1
BillableDi George's syndrome
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D82.1 an HCC code?
Yes. D82.1 maps to Disorders of Immunity, Neutropenia under the CMS-HCC V28 risk adjustment model (and Disorders of Immunity under V24).
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 D82.1
For D82.1 to 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 D82.1 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D82.1 is the ICD-10-CM diagnosis code for di george's syndrome. A rare genetic disorder where the thymus gland (which produces immune cells) and parathyroid glands fail to develop properly, leading to immune deficiency and low calcium levels. D82.1 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 CMS-HCC V28 risk adjustment model, D82.1 maps to Disorders of Immunity, Neutropenia (HCC 115) with a community, non-dual, aged base RAF weight of 0.369. Under the older CMS-HCC V24 model, D82.1 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.
This syndrome involves multiple organ systems; document cardiac defects, cleft palate, and hypocalcemia separately if present. Because D82.1 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 D82.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This syndrome involves multiple organ systems; document cardiac defects, cleft palate, and hypocalcemia separately if present
- •Also known as 22q11 deletion syndrome; document associated conditions comprehensively for complete clinical documentation
Clinical Significance
DiGeorge syndrome, also known as 22q11.2 deletion syndrome, is a congenital immunodeficiency resulting from abnormal development of the third and fourth pharyngeal pouches, causing thymic hypoplasia or aplasia, parathyroid hypoplasia with hypocalcemia, conotruncal cardiac defects, and characteristic facial features. The immune deficiency primarily affects T-cell development due to absent or small thymus.
Documentation Requirements
- ✓Documentation must include genetic testing confirming 22q11.2 deletion (fluorescence in situ hybridization or chromosomal microarray), T-cell enumeration, cardiac evaluation results, calcium and parathyroid hormone levels, facial dysmorphology description, and developmental assessment.
- ✓Document the severity of immunodeficiency (complete vs.
- ✓partial DiGeorge) and all affected organ systems comprehensively.