E71.528 ICD-10-CM Code: Other X-linked adrenoleukodystrophy
E71.528 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Metabolic disorders (E70-E88)
E71.528
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther X-linked adrenoleukodystrophy
Other forms of X-linked adrenoleukodystrophy not classified as childhood or adolescent types, including rare presentations or variants of this genetic nervous system disorder.
Buddy Insight
This code captures atypical presentations of X-linked adrenoleukodystrophy not fitting childhood, adolescent, or adrenomyeloneuropathy classifications, including the Addison-only phenotype where isolated adrenal insufficiency occurs without neurological involvement, or asymptomatic males with elevated very long chain fatty acids identified through family screening.
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
Official- Addison only phenotype adrenoleukodystrophy
- Addison-Schilder adrenoleukodystrophy
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E71.528 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for E71.528 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for E71.528 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E71.528 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for E71.528 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for E71.528 in this effective period.
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 E71.528 an HCC code?
Yes. E71.528 maps to Other Significant Endocrine and Metabolic Disorders under the V24 model but is not retained in V28.
- Code
- E71.528
- Description
- Other X-linked adrenoleukodystrophy
- 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 E71.528 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for E71.528
For E71.528 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 E71.528 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
E71.528 is the ICD-10-CM diagnosis code for other x-linked adrenoleukodystrophy. Other forms of X-linked adrenoleukodystrophy not classified as childhood or adolescent types, including rare presentations or variants of this genetic nervous system disorder. E71.528 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, E71.528 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.
Use this code for atypical presentations or variants of X-linked adrenoleukodystrophy that don't fit standard childhood or adolescent categories. Because E71.528 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 E71.528 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code for atypical presentations or variants of X-linked adrenoleukodystrophy that don't fit standard childhood or adolescent categories
- •Document the specific clinical presentation, age of onset, and progression pattern to justify use of this 'other' category code
Clinical Significance
This code captures atypical presentations of X-linked adrenoleukodystrophy not fitting childhood, adolescent, or adrenomyeloneuropathy classifications, including the Addison-only phenotype where isolated adrenal insufficiency occurs without neurological involvement, or asymptomatic males with elevated very long chain fatty acids identified through family screening. These patients require ongoing neurological surveillance as cerebral disease can develop at any age.
Documentation Requirements
- ✓Document the specific X-linked adrenoleukodystrophy presentation, ABCD1 gene mutation, very long chain fatty acid levels, adrenal function testing, neurological assessment showing absence of typical cerebral or spinal patterns, and surveillance plan.
- ✓Record reason the presentation does not fit standard categories.
Commonly Confused Codes
- •E71.520-E71.522 for standard childhood, adolescent, or adrenomyeloneuropathy presentations
- •E71.529 (X-linked adrenoleukodystrophy, unspecified type) when the presentation has not been characterized
- •E27.1 (Primary adrenocortical insufficiency) when adrenal disease is recognized but the underlying X-linked adrenoleukodystrophy is missed.