What is ICD-10 code D89.1?

D89.1 is the ICD-10-CM diagnosis code for Cryoglobulinemia. A condition where abnormal proteins in the blood precipitate in cold temperatures, causing inflammation and damage to blood vessels, nerves, and organs. D89.1 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D89.1 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. D89.1 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. D89.1 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 D89.1?

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. D89.1 was a payment HCC under V24 (Other Significant Endocrine and Metabolic Disorders) 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 D89.1?

Specify the type of cryoglobulinemia (Type I, II, or III) if documented Document associated conditions such as hepatitis C, which is a common cause of Type II cryoglobulinemia Because D89.1 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.

D89.1 ICD-10 Code: Cryoglobulinemia | Other

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 lookupD89.1Effective 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)

D89.1

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

Cryoglobulinemia

A condition where abnormal proteins in the blood precipitate in cold temperatures, causing inflammation and damage to blood vessels, nerves, and organs.

Buddy Insight

Cryoglobulinemia involves the presence of abnormal immunoglobulins that precipitate at temperatures below 37 degrees Celsius, causing vasculitis and end-organ damage.

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Mapped

HCC 23

Other Significant Endocrine a...

RAF 0.230

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 23

Other Significant Endocrine a...

RAF 0.0

RXHCC

Mapped

HCC 99

Immunodeficiencies

RAF 0.0

Code Trumping

Basket needed

Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

D89Other disorders involving the immune mechanism, not elsewhere classified

D89.1Cryoglobulinemia

Inclusion Terms

Official

Cryoglobulinemic purpura
Cryoglobulinemic vasculitis
Essential cryoglobulinemia
Idiopathic cryoglobulinemia
Mixed cryoglobulinemia

Excludes 2

Official

transplant failure and rejection (T86.-)

Related Child Codes

Official

D89.0Polyclonal hypergammaglobulinemia

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 D89.1 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 D89.1 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D89.1 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D89.1 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation must confirm the diagnosis of cryoglobulinemia with laboratory testing (positive cryoglobulin levels, cryocrit measurement) and clinical manifestations.

The type of cryoglobulinemia should be specified if known.

The underlying etiology (hepatitis C, lymphoproliferative disorder, autoimmune disease) must be documented.

Treatment details and organ involvement should be recorded.

MEAT Support

HCC Buddy guidance

Documentation must confirm the diagnosis of cryoglobulinemia with laboratory testing (positive cryoglobulin levels, cryocrit measurement) and clinical manifestations.

The type of cryoglobulinemia should be specified if known.

The underlying etiology (hepatitis C, lymphoproliferative disorder, autoimmune disease) must be documented.

Treatment details and organ involvement should be recorded.

Audit Caution

HCC Buddy guidance

Always investigate and code the underlying cause of cryoglobulinemia separately (hepatitis C, lymphoma, autoimmune disease).

Do not assign this code for cold agglutinin disease (D59.12), which is a different cold-reactive antibody disorder.

Ensure the cryoglobulinemia is symptomatic and clinically relevant rather than an incidental laboratory finding without clinical manifestations.

Common Mistakes

HCC Buddy guidance

D89.0 (Polyclonal hypergammaglobulinemia) involves elevated immunoglobulins without cold precipitation.

D47.2 (Monoclonal gammopathy) may be the underlying cause of Type I cryoglobulinemia but is a separate diagnosis.

M31.1 (Thrombotic microangiopathy) can present similarly with vasculitis.

B18.2 (Chronic viral hepatitis C) is the most common underlying cause and should be coded additionally when present.

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 D89.1 an HCC code?

Yes. D89.1 maps to Other Significant Endocrine and Metabolic Disorders under the V24 model but is not retained in V28.

HCC Category Mapping

V24HCC 23, Other Significant Endocrine and Metabolic Disorders

0.230

ESRDHCC 23, Other Significant Endocrine and Metabolic Disorders

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 D89.1

For D89.1to 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 D89.1 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

D89.1 is the ICD-10-CM diagnosis code for cryoglobulinemia. A condition where abnormal proteins in the blood precipitate in cold temperatures, causing inflammation and damage to blood vessels, nerves, and organs. D89.1 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, D89.1 maps to Other Significant Endocrine and Metabolic Disorders (HCC 23) with a community, non-dual, aged base RAF weight of 0.230. 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.

Specify the type of cryoglobulinemia (Type I, II, or III) if documented. Because D89.1 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 D89.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Specify the type of cryoglobulinemia (Type I, II, or III) if documented
•Document associated conditions such as hepatitis C, which is a common cause of Type II cryoglobulinemia

Clinical Significance

Cryoglobulinemia involves the presence of abnormal immunoglobulins that precipitate at temperatures below 37 degrees Celsius, causing vasculitis and end-organ damage. It is classified into three types: Type I (monoclonal, associated with hematologic malignancies), Type II (mixed monoclonal and polyclonal, strongly associated with hepatitis C), and Type III (polyclonal). Clinical manifestations include purpura, arthralgia, peripheral neuropathy, and glomerulonephritis.

Documentation Requirements

✓Documentation must confirm the diagnosis of cryoglobulinemia with laboratory testing (positive cryoglobulin levels, cryocrit measurement) and clinical manifestations.
✓The type of cryoglobulinemia should be specified if known.
✓The underlying etiology (hepatitis C, lymphoproliferative disorder, autoimmune disease) must be documented.
✓Treatment details and organ involvement should be recorded.

Commonly Confused Codes

•D89.0 (Polyclonal hypergammaglobulinemia) involves elevated immunoglobulins without cold precipitation.
•D47.2 (Monoclonal gammopathy) may be the underlying cause of Type I cryoglobulinemia but is a separate diagnosis.
•M31.1 (Thrombotic microangiopathy) can present similarly with vasculitis.
•B18.2 (Chronic viral hepatitis C) is the most common underlying cause and should be coded additionally when present.