E31.9
BillablePolyglandular dysfunction, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E31.9 an HCC code?
Yes. E31.9 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 E31.9
For E31.9 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 E31.9 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E31.9 is the ICD-10-CM diagnosis code for polyglandular dysfunction, unspecified. A condition affecting multiple hormone-producing glands, but the specific type or nature of the dysfunction is not documented. E31.9 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 CMS-HCC V28 risk adjustment model, E31.9 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, E31.9 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.
This is a non-specific code; query the provider for more detailed documentation to assign a more specific E31 code. Because E31.9 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 E31.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a non-specific code; query the provider for more detailed documentation to assign a more specific E31 code
- •Review lab results and clinical presentation to determine if a more specific diagnosis code applies
Clinical Significance
Polyglandular dysfunction involves failure or dysfunction of multiple endocrine glands simultaneously, leading to complex hormonal imbalances that can affect metabolism, growth, reproduction, and stress response. This unspecified code signals that the provider has identified multi-gland involvement but has not specified the exact syndrome or pattern, which is critical for accurate risk adjustment and treatment planning.
Documentation Requirements
- ✓Documentation must identify which endocrine glands are affected (adrenal, thyroid, parathyroid, gonadal, pancreatic) and the specific dysfunctions present.
- ✓Lab values including hormone levels (cortisol, thyroid-stimulating hormone, parathyroid hormone, insulin, sex hormones) should be recorded.
- ✓The provider should specify if this represents an autoimmune polyglandular syndrome (Type I, II, or III) to enable assignment of a more specific code.