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E72.19 ICD-10-CM Code: Other disorders of sulfur-bearing amino-acid metabolism

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

E72.19

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

Other disorders of sulfur-bearing amino-acid metabolism

Other rare metabolic disorders affecting sulfur-containing amino acids not classified elsewhere.

Buddy the Bee presenting code insight

Buddy Insight

This residual code captures disorders of sulfur-bearing amino acid metabolism not classified as homocystinuria or methylenetetrahydrofolate reductase deficiency, including conditions such as sulfite oxidase deficiency, methionine adenosyltransferase deficiency, and other rare defects in the transsulfuration or remethylation pathways.

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

HCC 23

RAF 0.230

ACA/HHS

0

0

RAF 0

ESRD/PACE

HCC 23

RAF 0.0

RXHCC

HCC 43

RAF 0.0

Code Trumping

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Code Book Path

Official
E72Other disorders of amino-acid metabolism
E72.1Disorders of sulfur-bearing amino-acid metabolism
E72.19Other disorders of sulfur-bearing amino-acid metabolism

Inclusion Terms

Official
  • Cystathioninuria
  • Methioninemia
  • Sulfite oxidase deficiency

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E72.19 in this effective period.

Related Child Codes

Official
E72.10Disorders of sulfur-bearing amino-acid metabolism, unspecified
E72.11Homocystinuria
E72.12Methylenetetrahydrofolate reductase deficiency

Includes

Official

ICD-10-CM does not list Includes notes for E72.19 in this effective period.

Excludes 1

Official
  • cystinosis (E72.04)
  • cystinuria (E72.01)
  • transcobalamin II deficiency (D51.2)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E72.19 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for E72.19 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for E72.19 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Document the specific sulfur amino acid disorder identified, relevant biochemical markers (plasma amino acids, urine sulfite testing), enzyme activity or genetic testing results, clinical manifestations, and management plan.
Record why the condition does not fit E72.11 or E72.12.

MEAT Support

HCC Buddy guidance
Document the specific sulfur amino acid disorder identified, relevant biochemical markers (plasma amino acids, urine sulfite testing), enzyme activity or genetic testing results, clinical manifestations, and management plan.
Record why the condition does not fit E72.11 or E72.12.

Audit Caution

HCC Buddy guidance
This is an 'other specified' code requiring documentation of a specific disorder.
Do not use as a substitute for the unspecified code when diagnostic workup is incomplete.

Common Mistakes

HCC Buddy guidance
E72.11 (Homocystinuria) for cystathionine beta-synthase deficiency
E72.12 (Methylenetetrahydrofolate reductase deficiency) for that specific enzyme defect
E72.10 (Disorders of sulfur-bearing amino-acid metabolism, unspecified) when the type is truly unknown.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is E72.19 an HCC code?

Yes. E72.19 maps to Other Significant Endocrine and Metabolic Disorders under the V24 model but is not retained in V28.

HCC Category Mapping

V24HCC 23, Other Significant Endocrine and Metabolic Disorders
0.230
ESRDHCC 23, Other Significant Endocrine and Metabolic Disorders
0.000
RxHCCHCC 43, Other Significant Endocrine and Metabolic Disorders
0.000

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 E72.19

For E72.19to 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 E72.19 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

E72.19 is the ICD-10-CM diagnosis code for other disorders of sulfur-bearing amino-acid metabolism. Other rare metabolic disorders affecting sulfur-containing amino acids not classified elsewhere. E72.19 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, E72.19 maps to Other Significant Endocrine and Metabolic Disorders (HCC 23) with a community, non-dual, aged base RAF weight of 0.230. 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 sulfur-bearing amino acid disorders that don't fit into homocystinuria or methylenetetrahydrofolate reductase deficiency categories. Because E72.19 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 E72.19 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code for sulfur-bearing amino acid disorders that don't fit into homocystinuria or methylenetetrahydrofolate reductase deficiency categories
  • Provide specific documentation of the disorder type to support medical necessity

Clinical Significance

This residual code captures disorders of sulfur-bearing amino acid metabolism not classified as homocystinuria or methylenetetrahydrofolate reductase deficiency, including conditions such as sulfite oxidase deficiency, methionine adenosyltransferase deficiency, and other rare defects in the transsulfuration or remethylation pathways. Clinical presentations vary from benign biochemical variants to severe neurological disease depending on the specific enzyme involved.

Documentation Requirements

  • Document the specific sulfur amino acid disorder identified, relevant biochemical markers (plasma amino acids, urine sulfite testing), enzyme activity or genetic testing results, clinical manifestations, and management plan.
  • Record why the condition does not fit E72.11 or E72.12.

Commonly Confused Codes

  • E72.11 (Homocystinuria) for cystathionine beta-synthase deficiency
  • E72.12 (Methylenetetrahydrofolate reductase deficiency) for that specific enzyme defect
  • E72.10 (Disorders of sulfur-bearing amino-acid metabolism, unspecified) when the type is truly unknown.

Child Codes

Code Hierarchy

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