D86.3 maps to CMS-HCC V28 387. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupD86.3

Effective 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)

D86.3

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

Sarcoidosis of skin

Sarcoidosis affecting the skin, causing various skin lesions, rashes, or nodules that may be disfiguring or uncomfortable.

Buddy Insight

Cutaneous sarcoidosis manifests as granulomatous skin lesions including papules, plaques, nodules, erythema nodosum, and the distinctive lupus pernio affecting the nose, cheeks, and ears.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 387

Pemphigus, Pemphigoid, and Ot...

Coefficient HCC 387: 0.406 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

D86Sarcoidosis D86.3Sarcoidosis of skin

Inclusion Terms

Official

No inclusion terms are included in this display for D86.3. Check the code and parent instructions in the Code Book.

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

Official

D86.0Sarcoidosis of lung D86.1Sarcoidosis of lymph nodes D86.2Sarcoidosis of lung with sarcoidosis of lymph nodes D86.8Sarcoidosis of other sites D86.9Sarcoidosis, unspecified

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

Official

No Code First sequencing instructions are included in this display for D86.3. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for D86.3. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for D86.3. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

The provider must document the specific diagnosis of sarcoidosis of the skin with description of the cutaneous manifestations (type and distribution of lesions).

Biopsy confirmation showing non-caseating granulomas is the gold standard.

Documentation should note whether systemic involvement has been evaluated and any associated treatment such as topical or systemic corticosteroids or immunomodulators.

MEAT Support

HCC Buddy guidance

The provider must document the specific diagnosis of sarcoidosis of the skin with description of the cutaneous manifestations (type and distribution of lesions).

Biopsy confirmation showing non-caseating granulomas is the gold standard.

Documentation should note whether systemic involvement has been evaluated and any associated treatment such as topical or systemic corticosteroids or immunomodulators.

Audit Caution

HCC Buddy guidance

Do not assign this code for skin findings that are merely suspected to be sarcoidosis without confirmatory documentation or biopsy.

Erythema nodosum associated with sarcoidosis should be coded here rather than with a standalone erythema nodosum code (L52) when sarcoidosis is the confirmed etiology.

If the patient has both skin and lung sarcoidosis, assign both D86.3 and D86.0 or D86.2 as appropriate.

Common Mistakes

HCC Buddy guidance

D86.0 through D86.2 capture pulmonary and lymph node sarcoidosis without skin involvement.

L93.0 (Discoid lupus erythematosus) can mimic sarcoid skin lesions clinically.

L28.0 (Lichen simplex chronicus) and L44.0 (Pityriasis rubra pilaris) may present with similar papular or plaque-like lesions.

D86.89 (Sarcoidosis of other sites) is for non-skin, non-lung extrapulmonary sarcoidosis.

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 D86.3 an HCC code?

Yes. D86.3 (Sarcoidosis of skin) maps to HCC 387, Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.406. 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: D86.3 is billable and maps to V28 HCC 387, Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: D86.3
Description: Sarcoidosis of skin
HCC (V28): HCC 387 — Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders
RAF reference coefficient: 0.406
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 387, Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders

0.406

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 D86.3 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for D86.3

For D86.3, 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

D86.3 is the ICD-10-CM diagnosis code for sarcoidosis of skin. Sarcoidosis affecting the skin, causing various skin lesions, rashes, or nodules that may be disfiguring or uncomfortable. D86.3 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, D86.3 maps to Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders (HCC 387) with a source-labeled community, non-dual, aged reference coefficient of 0.406. 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.

Specify the type of skin manifestation if documented (erythema nodosum, lupus pernio, etc.). For D86.3, 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 D86.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Specify the type of skin manifestation if documented (erythema nodosum, lupus pernio, etc.)
•May occur with systemic sarcoidosis affecting other organs

Clinical Significance

Cutaneous sarcoidosis manifests as granulomatous skin lesions including papules, plaques, nodules, erythema nodosum, and the distinctive lupus pernio affecting the nose, cheeks, and ears. While often considered a milder form of sarcoidosis, skin involvement can be disfiguring and may signal systemic disease that requires investigation for pulmonary, cardiac, or neurologic involvement. Lupus pernio in particular is associated with chronic, treatment-resistant disease.

Documentation Requirements

✓The provider must document the specific diagnosis of sarcoidosis of the skin with description of the cutaneous manifestations (type and distribution of lesions).
✓Biopsy confirmation showing non-caseating granulomas is the gold standard.
✓Documentation should note whether systemic involvement has been evaluated and any associated treatment such as topical or systemic corticosteroids or immunomodulators.

Commonly Confused Codes

•D86.0 through D86.2 capture pulmonary and lymph node sarcoidosis without skin involvement.
•L93.0 (Discoid lupus erythematosus) can mimic sarcoid skin lesions clinically.
•L28.0 (Lichen simplex chronicus) and L44.0 (Pityriasis rubra pilaris) may present with similar papular or plaque-like lesions.
•D86.89 (Sarcoidosis of other sites) is for non-skin, non-lung extrapulmonary sarcoidosis.