E00.0
BillableCongenital iodine-deficiency syndrome, neurological type
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E00.0 an HCC code?
No. E00.0 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
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 E00.0
For E00.0 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 E00.0 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E00.0 is the ICD-10-CM diagnosis code for congenital iodine-deficiency syndrome, neurological type. A birth defect caused by severe iodine deficiency during pregnancy, resulting in intellectual disability, growth problems, and neurological damage in the newborn. E00.0 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering disorders of thyroid gland (e00-e07).
E00.0 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 any HCC under V24 or V28, so it does not directly contribute to community risk adjustment scores. It maps to RxHCC 44 (Osteoporosis, Vertebral and Pathological Fractures). While it lacks CMS-HCC community model impact, accurate coding supports prescription drug plan risk adjustment and clinical completeness.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E00.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a congenital condition; document maternal iodine deficiency history and neonatal screening results
- •Differentiate from other congenital hypothyroidism codes; this specifically indicates iodine deficiency etiology
Clinical Significance
Congenital iodine-deficiency syndrome, neurological type (neurological cretinism), results from severe iodine deficiency during fetal development, causing irreversible neurological damage including intellectual disability, spastic diplegia, deaf-mutism, and motor impairment. This condition is virtually eliminated in countries with adequate iodine supplementation programs but remains a concern in endemic iodine-deficient regions. The neurological damage is permanent and occurs primarily during the first and second trimesters.
Documentation Requirements
- ✓Documentation must establish the diagnosis of congenital iodine-deficiency syndrome with neurological manifestations, including intellectual disability, motor deficits, or hearing impairment attributable to prenatal iodine deficiency.
- ✓History of maternal iodine deficiency and thyroid function testing should be documented.
- ✓The neurological type is distinguished from the myxedematous type by the predominance of neurological over thyroid findings.
Commonly Confused Codes
- •E00.1 (Congenital iodine-deficiency syndrome, myxedematous type) presents primarily with hypothyroid features rather than neurological damage.
- •E00.2 (Mixed type) combines features of both.
- •E03.0 (Congenital hypothyroidism with diffuse goiter) and E03.1 (Congenital hypothyroidism without goiter) represent hypothyroidism from other causes.
- •F70-F79 (Intellectual disabilities) may be coded additionally for the neurological sequelae.