E07.0
BillableHypersecretion of calcitonin
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E07.0 an HCC code?
No. E07.0 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 E07.0
For E07.0to 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 E07.0 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E07.0 is the ICD-10-CM diagnosis code for hypersecretion of calcitonin. Excessive production of calcitonin, a hormone that regulates calcium levels, which can indicate medullary thyroid cancer or other endocrine disorders. E07.0 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).
E07.0 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.
Maps to RxHCC 44 (Osteoporosis, Vertebral and Pathological Fractures) in the prescription drug model. This code does not map to CMS-HCC v28 or v24 models. If the underlying cause is medullary thyroid carcinoma, the malignancy code (C73) would carry significantly higher HCC risk adjustment value.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E07.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Elevated calcitonin levels warrant investigation for medullary thyroid carcinoma
- •Document baseline and stimulated calcitonin levels when available
Clinical Significance
Hypersecretion of calcitonin indicates excessive production of calcitonin, most commonly associated with medullary thyroid carcinoma (MTC), C-cell hyperplasia, or rarely as a paraneoplastic phenomenon. Elevated calcitonin serves as both a diagnostic marker and tumor surveillance tool for MTC, with levels correlating to tumor burden. This condition warrants thorough evaluation to exclude malignancy, particularly in patients with family history of MEN2 syndromes.
Documentation Requirements
- ✓Document the serum calcitonin level, the underlying cause of hypersecretion (medullary thyroid carcinoma, C-cell hyperplasia, or other), imaging findings, and whether genetic testing for RET proto-oncogene mutations has been performed.
- ✓If MTC is confirmed, a separate malignancy code should be assigned as the primary diagnosis.
Commonly Confused Codes
- •
- •
- •