E71.42 ICD-10-CM Code: Carnitine deficiency due to inborn errors of metabolism
HCC Buddy Code Card
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Metabolic disorders (E70-E88)
E71.42
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCarnitine deficiency due to inborn errors of metabolism
A carnitine deficiency that develops as a secondary consequence of another inherited metabolic disorder that affects the body's ability to produce or use carnitine.
Buddy Insight
Carnitine deficiency occurring as a secondary consequence of other inborn errors of metabolism, such as organic acidemias or fatty acid oxidation disorders, where accumulated metabolites conjugate with and deplete carnitine stores.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
MappedHCC 23
RAF 0.194
ACA/HHS
MappedHCC 28
Varies by metal level
ESRD/PACE
MappedHCC 23
RAF 0.036
RXHCC
MappedHCC 43
RAF 0.063
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for E71.42 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E71.42 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for E71.42 in this effective period.
Excludes 1
Official- Muscle carnitine palmitoyltransferase deficiency (E71.314)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E71.42 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for E71.42 in this effective period.
Code Also
Official- associated inborn error or metabolism
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 E71.42 an HCC code?
Yes. E71.42 maps to Other Significant Endocrine and Metabolic Disorders under the V24 model but is not retained in V28.
- Code
- E71.42
- Description
- Carnitine deficiency due to inborn errors of metabolism
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 E71.42 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for E71.42
For E71.42 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 E71.42 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
E71.42 is the ICD-10-CM diagnosis code for carnitine deficiency due to inborn errors of metabolism. A carnitine deficiency that develops as a secondary consequence of another inherited metabolic disorder that affects the body's ability to produce or use carnitine. E71.42 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, E71.42 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.
Always code the underlying inborn error of metabolism first, then sequence this code as a secondary diagnosis. Because E71.42 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 E71.42 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always code the underlying inborn error of metabolism first, then sequence this code as a secondary diagnosis
- •Common underlying conditions include organic acidemias and fatty acid oxidation disorders
Clinical Significance
Carnitine deficiency occurring as a secondary consequence of other inborn errors of metabolism, such as organic acidemias or fatty acid oxidation disorders, where accumulated metabolites conjugate with and deplete carnitine stores. This secondary depletion exacerbates the underlying metabolic disorder by further impairing fatty acid oxidation. Carnitine supplementation is an important adjunctive therapy for the primary condition.
Documentation Requirements
- ✓Document the underlying inborn error of metabolism causing the secondary carnitine deficiency, plasma carnitine levels showing depletion, acylcarnitine profile demonstrating conjugation pattern, and carnitine supplementation dosage.
- ✓The primary metabolic condition should be coded first.
Code Also
- associated inborn error or metabolism