What is ICD-10 code E70.328?

E70.328 is the ICD-10-CM diagnosis code for Other oculocutaneous albinism. It belongs to the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89). E70.328 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E70.328 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. E70.328 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. E70.328 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 E70.328 map to under V28?

E70.328 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

What does E70.328 pay in RAF?

E70.328 has no separately stated V28 community RAF weight. If it is not a V28 payment HCC, it adds nothing to a community RAF score.

What is the V28 vs V24 difference for E70.328?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. E70.328 was a payment HCC under V24 (Other Significant Endocrine and Metabolic Disorders) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

What documentation supports E70.328?

Verify the specific type of oculocutaneous albinism documented by the provider, as codes E70.320-E70.329 distinguish between different subtypes; E70.328 is used when the type doesn't fit other specified categories Ensure documentation clearly indicates involvement of both eyes and skin; if only one system is affected, a different albinism code may be more appropriate Because E70.328 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. MEAT is generic documentation evidence, not a payer-specific rule.

2026 ICD-10-CM E70.328: Other oculocutaneous

E70.328 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 lookupE70.328Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Metabolic disorders (E70-E88)

E70.328

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

Other oculocutaneous albinism

This code describes a rare form of albinism that affects both the skin and eyes, causing reduced pigmentation in these areas. It is a genetic condition where the body cannot properly produce or distribute melanin, the pigment responsible for skin and eye color.

Buddy Insight

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Mapped

HCC 23

Other Significant Endocrine a...

RAF 0.194

ACA/HHS

Mapped

HCC 28

HHS-HCC 28

Varies by metal level

ESRD/PACE

Mapped

HCC 23

Other Significant Endocrine a...

RAF 0.036

RXHCC

Mapped

HCC 43

Other Significant Endocrine a...

RAF 0.063

Code Book Path

Official

E70.3Albinism

E70.32Oculocutaneous albinism

E70.328Other oculocutaneous albinism

Inclusion Terms

Official

Cross syndrome

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E70.328 in this effective period.

Related Child Codes

Official

E70.320Tyrosinase negative oculocutaneous albinism

E70.321Tyrosinase positive oculocutaneous albinism

E70.329Oculocutaneous albinism, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for E70.328 in this effective period.

Excludes 1

Official

Chediak-Higashi syndrome (E70.330)
Hermansky-Pudlak syndrome (E70.331)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E70.328 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for E70.328 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for E70.328 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation should specify the genetic mutation or clinical subtype identified, detailed pigmentation assessment of skin, hair, and eyes, ophthalmologic examination findings, and genetic counseling records.

The provider should document why this case does not fit the tyrosinase-negative or tyrosinase-positive categories.

Family history and inheritance pattern analysis should be included.

MEAT Support

HCC Buddy guidance

The provider should document why this case does not fit the tyrosinase-negative or tyrosinase-positive categories.

Family history and inheritance pattern analysis should be included.

Audit Caution

HCC Buddy guidance

Use this code only when the oculocutaneous albinism type has been identified but does not fit the tyrosinase-negative or tyrosinase-positive categories.

Do not use as a default when genetic testing has not been performed.

Code all ophthalmologic and dermatologic complications separately.

Document the specific genetic or clinical basis for this classification.

Common Mistakes

HCC Buddy guidance

E70.320 (Tyrosinase negative) and E70.321 (Tyrosinase positive) are for the classic subtypes.

E70.329 (Oculocutaneous albinism, unspecified) is for cases where the subtype truly cannot be determined.

E70.310-E70.319 (Ocular albinism) involves only the eyes.

E70.330-E70.339 (Albinism with hematologic abnormality) involves blood cell disorders.

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 E70.328 an HCC code?

Yes. E70.328 maps to Other Significant Endocrine and Metabolic Disorders under the V24 model but is not retained in V28.

Code: E70.328
Description: Other oculocutaneous albinism
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

V24HCC 23, Other Significant Endocrine and Metabolic Disorders

0.194

ESRDHCC 23, Other Significant Endocrine and Metabolic Disorders

0.036

RxHCCHCC 43, Other Significant Endocrine and Metabolic Disorders

0.063

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work E70.328 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for E70.328

For E70.328 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 E70.328 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

E70.328 is the ICD-10-CM diagnosis code for other oculocutaneous albinism. This code describes a rare form of albinism that affects both the skin and eyes, causing reduced pigmentation in these areas. It is a genetic condition where the body cannot properly produce or distribute melanin, the pigment responsible for skin and eye color. E70.328 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering metabolic disorders (e70-e88).

Under the older CMS-HCC V24 model, E70.328 maps to Other Significant Endocrine and Metabolic Disorders (HCC 23) with a community, non-dual, aged base RAF weight of 0.194. 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.

Verify the specific type of oculocutaneous albinism documented by the provider, as codes E70.320-E70.329 distinguish between different subtypes; E70.328 is used when the type doesn't fit other specified categories. Because E70.328 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 E70.328 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify the specific type of oculocutaneous albinism documented by the provider, as codes E70.320-E70.329 distinguish between different subtypes; E70.328 is used when the type doesn't fit other specified categories
•Ensure documentation clearly indicates involvement of both eyes and skin; if only one system is affected, a different albinism code may be more appropriate

Clinical Significance

Other oculocutaneous albinism captures rare subtypes beyond the classic tyrosinase-negative and tyrosinase-positive forms, including Types 3 (TYRP1 mutations, more common in individuals of African descent) and Type 4 (SLC45A2 mutations). These forms vary in severity of pigment reduction and associated visual impairment, and proper subtype identification is important for genetic counseling and management optimization.

Documentation Requirements

✓Documentation should specify the genetic mutation or clinical subtype identified, detailed pigmentation assessment of skin, hair, and eyes, ophthalmologic examination findings, and genetic counseling records.
✓The provider should document why this case does not fit the tyrosinase-negative or tyrosinase-positive categories.
✓Family history and inheritance pattern analysis should be included.

Commonly Confused Codes

•E70.320 (Tyrosinase negative) and E70.321 (Tyrosinase positive) are for the classic subtypes.
•E70.329 (Oculocutaneous albinism, unspecified) is for cases where the subtype truly cannot be determined.
•E70.310-E70.319 (Ocular albinism) involves only the eyes.
•E70.330-E70.339 (Albinism with hematologic abnormality) involves blood cell disorders.