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E26.02

Billable

Glucocorticoid-remediable aldosteronism

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is E26.02 an HCC code?

Yes. E26.02 maps to Other Significant Endocrine and Metabolic Disorders under the V24 model but is not retained in V28.

HCC Category Mapping

V24HCC 23Other Significant Endocrine and Metabolic Disorders
0.230
ESRDHCC 23Other Significant Endocrine and Metabolic Disorders
0.000
RxHCCHCC 43Other Significant Endocrine and Metabolic Disorders
0.000

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 E26.02

For E26.02to 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 E26.02 during that encounter — not just copy-forwarded from a problem list.

What This Code Means

E26.02 is the ICD-10-CM diagnosis code for glucocorticoid-remediable aldosteronism. A rare inherited form of high blood pressure caused by excessive aldosterone production that can be controlled with glucocorticoid medications. E26.02 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 older CMS-HCC V24 model, E26.02 maps to Other Significant Endocrine and Metabolic Disorders (HCC 23) with a community, non-dual, aged base RAF weight of 0.230. 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.

This is a specific genetic form; ensure documentation confirms glucocorticoid-remediable type. Because E26.02 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 E26.02 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This is a specific genetic form; ensure documentation confirms glucocorticoid-remediable type
  • Note the response to glucocorticoid therapy in the medical record

Clinical Significance

Glucocorticoid-remediable aldosteronism (familial hyperaldosteronism type I) is a rare autosomal dominant genetic condition caused by a chimeric gene fusion that places aldosterone synthase under adrenocorticotropic hormone control. This results in aldosterone overproduction that uniquely responds to low-dose glucocorticoid suppression, distinguishing it from other forms of primary hyperaldosteronism.

Documentation Requirements

  • Document genetic testing confirmation of the chimeric CYP11B1/CYP11B2 gene, family history of early-onset hypertension or hemorrhagic stroke, response to glucocorticoid suppression therapy, aldosterone and renin levels, and blood pressure control.

Commonly Confused Codes

  • E26.01 (Conn syndrome from adrenal adenoma), E26.09 (other primary hyperaldosteronism from bilateral hyperplasia), E26.1 (secondary hyperaldosteronism).

Code Hierarchy

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