What is ICD-10 code E34.4?

E34.4 is the ICD-10-CM diagnosis code for Constitutional tall stature. It belongs to the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89). E34.4 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E34.4 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. E34.4 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. E34.4 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does E34.4 map to under V28?

E34.4 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for E34.4?

E34.4 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for E34.4?

E34.4 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports E34.4?

This is a benign condition and should not be confused with pathological causes of tall stature such as gigantism or acromegaly, which have different codes Verify documentation clearly indicates constitutional (genetic/familial) tall stature rather than height related to endocrine disorders or other medical conditions E34.4 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM E34.4: Constitutional tall stature

E34.4 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

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Code lookupE34.4Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Disorders of other endocrine glands (E20-E35)

E34.4

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Constitutional tall stature

This code describes a person who is naturally very tall due to their genetic makeup or constitutional factors, rather than due to a disease or medical condition. It's used when someone's height is simply part of their normal physical development.

Buddy Insight

Constitutional tall stature is a normal variant where an individual's height exceeds the 97th percentile due to genetic and familial factors rather than pathological causes.

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 030

HHS-HCC 030 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 23

Other Significant Endocrine a...

Code-level coefficient reference

RXHCC

Mapped

HCC 43

Pituitary, Adrenal Gland, and...

Code-level coefficient reference

Code Book Path

Official

E34Other endocrine disorders

E34.4Constitutional tall stature

Inclusion Terms

Official

Constitutional gigantism

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E34.4 in this effective period.

Related Child Codes

Official

E34.0Carcinoid syndrome

E34.1Other hypersecretion of intestinal hormones

E34.2Ectopic hormone secretion, not elsewhere classified

E34.3Short stature due to endocrine disorder

E34.5Androgen insensitivity syndrome

Includes

Official

ICD-10-CM does not list Includes notes for E34.4 in this effective period.

Excludes 1

Official

pseudohypoparathyroidism (E20.1)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E34.4 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for E34.4 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for E34.4 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation should include the patient's height, height percentile for age, growth velocity, parental heights and target height calculation, and bone age assessment.

The provider should explicitly state that tall stature is constitutional in nature and document the exclusion of pathological causes including Marfan syndrome, homocystinuria, growth hormone excess, and chromosomal abnormalities.

MEAT Support

HCC Buddy guidance

Documentation should include the patient's height, height percentile for age, growth velocity, parental heights and target height calculation, and bone age assessment.

Audit Caution

HCC Buddy guidance

Do not assign this code when documentation suggests a pathological cause of tall stature, as the underlying condition should be coded instead.

This is a benign condition and should not be confused with gigantism or other growth disorders.

Ensure the provider has documented this as constitutional rather than simply noting the patient is tall without clinical assessment of etiology.

Common Mistakes

HCC Buddy guidance

E22.0 (Acromegaly and pituitary gigantism) is used for growth hormone excess.

Q87.40 (Marfan syndrome, unspecified) should be coded when that connective tissue disorder is the cause of tall stature.

Q96-Q99 (Chromosomal abnormalities) may cause tall stature in conditions like Klinefelter syndrome.

E34.8 (Other specified endocrine disorders) may be applicable for other endocrine causes of excessive growth.

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 E34.4 an HCC code?

E34.4 is not in the CMS-HCC V28 or V24 community payment model. E34.4 has a separate mapping under the CMS-HCC ESRD model (HCC 23 (Other Significant Endocrine and Metabolic Disorders)) and the Part D RxHCC model (HCC 43 (Pituitary, Adrenal Gland, and Other Endocrine and Metabolic Disorders)); the applicable result needs member context. E34.4 also appears in the HHS-HCC commercial risk model (HCC 030 (HHS-HCC 030 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping.

Code: E34.4
Description: Constitutional tall stature
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

ESRDHCC 23, Other Significant Endocrine and Metabolic Disorders

Not separately weighted

RxHCCHCC 43, Pituitary, Adrenal Gland, and Other Endocrine and Metabolic Disorders

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work E34.4 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for E34.4

For E34.4 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 E34.4 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

E34.4 is the ICD-10-CM diagnosis code for constitutional tall stature. This code describes a person who is naturally very tall due to their genetic makeup or constitutional factors, rather than due to a disease or medical condition. It's used when someone's height is simply part of their normal physical development. E34.4 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).

E34.4 has no mapping under the CMS-HCC V28 or V24 community payment models. E34.4 has a separate mapping under the CMS-HCC ESRD model (HCC 23 (Other Significant Endocrine and Metabolic Disorders)) and the Part D RxHCC model (HCC 43 (Pituitary, Adrenal Gland, and Other Endocrine and Metabolic Disorders)); the applicable result needs member context. E34.4 also appears in the HHS-HCC commercial risk model (HCC 030 (HHS-HCC 030 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

This is a benign condition and should not be confused with pathological causes of tall stature such as gigantism or acromegaly, which have different codes.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for E34.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This is a benign condition and should not be confused with pathological causes of tall stature such as gigantism or acromegaly, which have different codes
•Verify documentation clearly indicates constitutional (genetic/familial) tall stature rather than height related to endocrine disorders or other medical conditions

Clinical Significance

Constitutional tall stature is a normal variant where an individual's height exceeds the 97th percentile due to genetic and familial factors rather than pathological causes. While not a disease per se, documentation of this condition helps differentiate benign tall stature from pathological causes such as Marfan syndrome, Klinefelter syndrome, or growth hormone excess that require different management approaches.

Documentation Requirements

✓Documentation should include the patient's height, height percentile for age, growth velocity, parental heights and target height calculation, and bone age assessment.
✓The provider should explicitly state that tall stature is constitutional in nature and document the exclusion of pathological causes including Marfan syndrome, homocystinuria, growth hormone excess, and chromosomal abnormalities.

Commonly Confused Codes

•E22.0 (Acromegaly and pituitary gigantism) is used for growth hormone excess.
•Q87.40 (Marfan syndrome, unspecified) should be coded when that connective tissue disorder is the cause of tall stature.
•Q96-Q99 (Chromosomal abnormalities) may cause tall stature in conditions like Klinefelter syndrome.
•E34.8 (Other specified endocrine disorders) may be applicable for other endocrine causes of excessive growth.