E22.0
BillableAcromegaly and pituitary gigantism
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E22.0 an HCC code?
Yes. E22.0 maps to Other Significant Endocrine and Metabolic Disorders under the CMS-HCC V28 risk adjustment model (and Other Significant Endocrine and Metabolic Disorders under V24).
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 E22.0
For E22.0 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 E22.0 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E22.0 is the ICD-10-CM diagnosis code for acromegaly and pituitary gigantism. A condition where the pituitary gland produces excessive growth hormone, causing abnormal growth and enlargement of body tissues and bones in adults (acromegaly) or excessive growth in children (gigantism). E22.0 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering disorders of other endocrine glands (e20-e35).
Under the CMS-HCC V28 risk adjustment model, E22.0 maps to Other Significant Endocrine and Metabolic Disorders (HCC 51) with a community, non-dual, aged base RAF weight of 0.233. Under the older V24 model, E22.0 mapped to the same category but with a base RAF weight of 0.230 — V28 recalibrated weights across the entire model. 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.
Distinguish between acromegaly (adult-onset) and pituitary gigantism (childhood-onset) as they may have different clinical implications. Because E22.0 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 E22.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Distinguish between acromegaly (adult-onset) and pituitary gigantism (childhood-onset) as they may have different clinical implications
- •Look for associated complications like diabetes, hypertension, or joint problems that should be coded separately
Clinical Significance
Acromegaly and pituitary gigantism are caused by excess growth hormone production, typically from a pituitary adenoma. Acromegaly in adults causes progressive enlargement of hands, feet, and facial features with significant cardiovascular, metabolic, and joint complications. Pituitary gigantism in children causes excessive linear growth before epiphyseal closure.
Documentation Requirements
- ✓Document the underlying cause (pituitary adenoma size and location), growth hormone and insulin-like growth factor 1 levels, associated complications (diabetes mellitus, cardiomyopathy, sleep apnea, joint disease), treatment status (surgery, medication, radiation), and disease activity.