What is ICD-10 code D89.0?

D89.0 is the ICD-10-CM diagnosis code for Polyclonal hypergammaglobulinemia. An abnormal increase in immunoglobulins (antibody proteins) in the blood, which can occur in various infections, autoimmune diseases, or lymphoproliferative disorders. D89.0 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D89.0 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. D89.0 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. D89.0 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.

Which HCC does D89.0 map to under V28?

D89.0 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

What does D89.0 pay in RAF?

D89.0 has no separately stated V28 community RAF weight. If it is not a V28 payment HCC, it adds nothing to a community RAF score.

What is the V28 vs V24 difference for D89.0?

D89.0 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards D89.0 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. It does, however, map under the Part D RxHCC model (Immunodeficiencies), which affects the ESRD and/or Part D (RxHCC) risk scores. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

What documentation supports D89.0?

Identify and code the underlying cause if documented (infection, autoimmune disease, malignancy) This is often a laboratory finding; ensure clinical significance is documented D89.0 is not a CMS-HCC payment code, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM D89.0: Polyclonal hypergammaglobulinemia

D89.0 is not a CMS-HCC payment code. 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 lookupD89.0Effective 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)

D89.0

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

Polyclonal hypergammaglobulinemia

An abnormal increase in immunoglobulins (antibody proteins) in the blood, which can occur in various infections, autoimmune diseases, or lymphoproliferative disorders.

Buddy Insight

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

N/A

—

Not risk-adjusted for this model/period.

Not mapped

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

Mapped

HCC 99

Immunodeficiencies

RAF 0.943

Code Book Path

Official

D89Other disorders involving the immune mechanism, not elsewhere classified

D89.0Polyclonal hypergammaglobulinemia

Inclusion Terms

Official

Benign hypergammaglobulinemic purpura
Polyclonal gammopathy NOS

Excludes 2

Official

transplant failure and rejection (T86.-)

Related Child Codes

Official

D89.1Cryoglobulinemia

D89.2Hypergammaglobulinemia, unspecified

D89.3Immune reconstitution syndrome

D89.4Mast cell activation syndrome and related disorders

D89.8Other specified disorders involving the immune mechanism, not elsewhere classified

Includes

Official

ICD-10-CM does not list Includes notes for D89.0 in this effective period.

Excludes 1

Official

hyperglobulinemia NOS (R77.1)
monoclonal gammopathy (of undetermined significance) (D47.2)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D89.0 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D89.0 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D89.0 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation should include serum protein electrophoresis results showing a broad-based (polyclonal) elevation in the gamma region, quantitative immunoglobulin levels, and the underlying condition driving the immune activation.

The provider should document the clinical context and any workup performed to exclude monoclonal gammopathy.

Treatment is directed at the underlying cause rather than the hypergammaglobulinemia itself.

MEAT Support

HCC Buddy guidance

The provider should document the clinical context and any workup performed to exclude monoclonal gammopathy.

Treatment is directed at the underlying cause rather than the hypergammaglobulinemia itself.

Audit Caution

HCC Buddy guidance

Do not assign this code for monoclonal elevations detected on serum protein electrophoresis; these require different codes. Ensure documentation confirms the polyclonal nature of the gammopathy. Code the underlying condition driving the immune activation as well, since polyclonal hypergammaglobulinemia is typically a secondary phenomenon. Do not confuse with hypogammaglobulinemia (D80.

codes).

Common Mistakes

HCC Buddy guidance

D47.2 (Monoclonal gammopathy) represents a clonal process and should not be confused with polyclonal elevation. C90.0

(Multiple myeloma) involves a malignant monoclonal plasma cell proliferation. D89.1 (Cryoglobulinemia) may coexist but represents a distinct pathology involving cold-precipitable immunoglobulins. R77.1 (Abnormality of globulin) is a less specific finding code.

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 D89.0 an HCC code?

D89.0 is not in the CMS-HCC V28 or V24 community payment model, but it does map to Immunodeficiencies under the Part D RxHCC model.

Code: D89.0
Description: Polyclonal hypergammaglobulinemia
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

RxHCCHCC 99, Immunodeficiencies

0.943

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work D89.0 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D89.0

For D89.0 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 D89.0 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D89.0 is the ICD-10-CM diagnosis code for polyclonal hypergammaglobulinemia. An abnormal increase in immunoglobulins (antibody proteins) in the blood, which can occur in various infections, autoimmune diseases, or lymphoproliferative disorders. D89.0 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).

D89.0 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

This code does not map to a CMS-HCC V28 payment category. Capture depends on documentation that supports the diagnosis; verify the HCC assignment against the current CMS mapping for the applicable payment year. Coders reviewing D89.0 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D89.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Identify and code the underlying cause if documented (infection, autoimmune disease, malignancy)
•This is often a laboratory finding; ensure clinical significance is documented

Clinical Significance

Polyclonal hypergammaglobulinemia represents a non-specific elevation of multiple immunoglobulin classes, typically reflecting chronic immune system activation rather than a clonal proliferative disorder. It is commonly associated with chronic infections (HIV, hepatitis), autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis), and chronic liver disease. Unlike monoclonal gammopathy, it does not carry a risk of progression to myeloma.

Documentation Requirements

✓Documentation should include serum protein electrophoresis results showing a broad-based (polyclonal) elevation in the gamma region, quantitative immunoglobulin levels, and the underlying condition driving the immune activation.
✓The provider should document the clinical context and any workup performed to exclude monoclonal gammopathy.
✓Treatment is directed at the underlying cause rather than the hypergammaglobulinemia itself.

Commonly Confused Codes

•D47.2 (Monoclonal gammopathy) represents a clonal process and should not be confused with polyclonal elevation. C90.0
•(Multiple myeloma) involves a malignant monoclonal plasma cell proliferation. D89.1 (Cryoglobulinemia) may coexist but represents a distinct pathology involving cold-precipitable immunoglobulins. R77.1 (Abnormality of globulin) is a less specific finding code.