E22.0 ICD-10-CM Code: Acromegaly and pituitary gigantism
E22.0 maps to CMS-HCC V28 51 (RAF 0.510). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC coding tools
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Disorders of other endocrine glands (E20-E35)
E22.0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAcromegaly 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).
Buddy Insight
Acromegaly and pituitary gigantism are caused by excess growth hormone production, typically from a pituitary adenoma.
CMS-HCC V28
MappedHCC 51
RAF 0.510
CMS-HCC V24
MappedHCC 23
RAF 0.194
ACA/HHS
MappedHCC 30
Varies by metal level
ESRD/PACE
MappedHCC 23
RAF 0.036
RXHCC
MappedHCC 42
RAF 2.110
Code Book Path
Inclusion Terms
Official- Overproduction of growth hormone
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E22.0 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for E22.0 in this effective period.
Excludes 1
Official- constitutional gigantism (E34.4)
- constitutional tall stature (E34.4)
- increased secretion from endocrine pancreas of growth hormone-releasing hormone (E16.8)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E22.0 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for E22.0 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for E22.0 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is E22.0 an HCC code?
Yes. E22.0 (Acromegaly and pituitary gigantism) maps to Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders under the CMS-HCC V28 risk adjustment model (and Other Significant Endocrine and Metabolic Disorders under V24), with a community non-dual aged RAF of 0.510. It is billable for payment year 2026.
Coder answer: E22.0 is billable and maps to V28 HCC 51, Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- E22.0
- Description
- Acromegaly and pituitary gigantism
- HCC (V28)
- HCC 51 — Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders
- RAF
- 0.510
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. 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.
Work E22.0 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
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.
Coder workflow notes
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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 Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders (HCC 51) with a community, non-dual, aged base RAF weight of 0.510. Under the older CMS-HCC V24 model, E22.0 maps to Other Significant Endocrine and Metabolic Disorders (HCC 23) with a community, non-dual, aged base RAF weight of 0.194. 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.