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D89.834 ICD-10-CM Code: Cytokine release syndrome, grade 4

ICD-10-CM Code View

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

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)

D89.834

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

Cytokine release syndrome, grade 4

A severe immune reaction with significant cytokine release causing serious systemic symptoms such as high fever, hypotension, and organ dysfunction, requiring intensive monitoring and treatment.

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

Basket needed

Code Book Path

Official
D89.8Other specified disorders involving the immune mechanism, not elsewhere classified
D89.83Cytokine release syndrome
D89.834Cytokine release syndrome, grade 4

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D89.834 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D89.834 in this effective period.

Related Child Codes

Official
D89.831Cytokine release syndrome, grade 1
D89.832Cytokine release syndrome, grade 2
D89.833Cytokine release syndrome, grade 3
D89.835Cytokine release syndrome, grade 5
D89.839Cytokine release syndrome, grade unspecified

Includes

Official

ICD-10-CM does not list Includes notes for D89.834 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D89.834 in this effective period.

Code First

Official
  • underlying cause, such as:
  • complications following infusion, transfusion and therapeutic injection (T80.89-)
  • complications of transplanted organs and tissue (T86.-)

Use Additional

Official
  • code for adverse effect, if applicable, to identify immune checkpoint inhibitors and immunostimulant drugs (T45.AX5)

Code Also

Official

ICD-10-CM does not list Code Also instructions for D89.834 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Grade 4 is life-threatening; document vital sign changes, organ involvement, and interventions required (vasopressors, ICU admission)
Correlate with the triggering immunotherapy and document the timeline of symptom onset

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 D89.834 an HCC code?

No. D89.834 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

D89.834 is the ICD-10-CM diagnosis code for cytokine release syndrome, grade 4. A severe immune reaction with significant cytokine release causing serious systemic symptoms such as high fever, hypotension, and organ dysfunction, requiring intensive monitoring and treatment. D89.834 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).

D89.834 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.

Grade 4 is life-threatening; document vital sign changes, organ involvement, and interventions required (vasopressors, ICU admission).

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D89.834 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Grade 4 is life-threatening; document vital sign changes, organ involvement, and interventions required (vasopressors, ICU admission)
  • Correlate with the triggering immunotherapy and document the timeline of symptom onset

Child Codes

Code Hierarchy

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