E28.2 ICD-10-CM Code: Polycystic ovarian syndrome
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Disorders of other endocrine glands (E20-E35)
E28.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePolycystic ovarian syndrome
Polycystic ovarian syndrome (PCOS) is a hormonal condition affecting women of reproductive age where the ovaries develop multiple small cysts and produce excess androgens (male hormones), leading to irregular periods, fertility issues, and metabolic problems. This is a common endocrine disorder that can affect weight, skin, and overall reproductive health.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
Official- Sclerocystic ovary syndrome
- Stein-Leventhal syndrome
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E28.2 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for E28.2 in this effective period.
Excludes 1
Official- isolated gonadotropin deficiency (E23.0)
- postprocedural ovarian failure (E89.4-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E28.2 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for E28.2 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for E28.2 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is E28.2 an HCC code?
No. E28.2 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
Get the V28 RAF + MEAT cheat sheet
One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.
Free PDF. No card. Unsubscribe anytime.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
E28.2 is the ICD-10-CM diagnosis code for polycystic ovarian syndrome. Polycystic ovarian syndrome (PCOS) is a hormonal condition affecting women of reproductive age where the ovaries develop multiple small cysts and produce excess androgens (male hormones), leading to irregular periods, fertility issues, and metabolic problems. This is a common endocrine disorder that can affect weight, skin, and overall reproductive health. E28.2 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).
E28.2 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.
PCOS is typically a chronic condition; ensure documentation supports the diagnosis and consider coding associated conditions like irregular menstruation (N92.-), infertility (N97.-), or metabolic syndrome (E88.81) if documented.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E28.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •PCOS is typically a chronic condition; ensure documentation supports the diagnosis and consider coding associated conditions like irregular menstruation (N92.-), infertility (N97.-), or metabolic syndrome (E88.81) if documented
- •Verify the clinical documentation clearly states 'polycystic ovarian syndrome' or 'PCOS' to justify this code; do not code based solely on ultrasound findings of multiple ovarian cysts without clinical correlation