E26.9
BillableHyperaldosteronism, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E26.9 an HCC code?
Yes. E26.9 maps to Other Significant Endocrine and Metabolic Disorders under the V24 model but is not retained in V28.
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 E26.9
For E26.9to 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 E26.9 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E26.9 is the ICD-10-CM diagnosis code for hyperaldosteronism, unspecified. Excessive aldosterone production where the specific type or cause has not been determined or specified. E26.9 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, E26.9 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 default code; attempt to determine if primary (E26.0x) or secondary (E26.1) before coding. Because E26.9 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 E26.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
Clinical Significance
Unspecified hyperaldosteronism indicates documented aldosterone excess without determination of whether it is primary (adrenal origin) or secondary (driven by renin-angiotensin system activation). This distinction is clinically critical because primary and secondary forms have fundamentally different treatment approaches.
Documentation Requirements
- ✓Query the provider for the type of hyperaldosteronism.
- ✓Document aldosterone levels, renin levels (suppressed in primary, elevated in secondary), potassium levels, blood pressure, and any diagnostic workup results or pending studies.