E74.820 ICD-10-CM Code: SLC13A5 Citrate Transporter Disorder
HCC Buddy Code Card
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Metabolic disorders (E70-E88)
E74.820
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSLC13A5 Citrate Transporter Disorder
A genetic disorder affecting the SLC13A5 protein, which normally helps transport citrate (a compound in the citric acid cycle) across cell membranes, leading to metabolic dysfunction.
Buddy Insight
SLC13A5 Citrate Transporter Disorder is an ultra-rare autosomal recessive neurometabolic condition caused by mutations in the SLC13A5 gene affecting citrate transport into cells.
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 E74.820 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E74.820 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for E74.820 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for E74.820 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E74.820 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for E74.820 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for E74.820 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 E74.820 an HCC code?
Yes. E74.820 maps to Other Significant Endocrine and Metabolic Disorders under the V24 model but is not retained in V28.
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 E74.820 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for E74.820
For E74.820to 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 E74.820 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
E74.820 is the ICD-10-CM diagnosis code for slc13a5 citrate transporter disorder. A genetic disorder affecting the SLC13A5 protein, which normally helps transport citrate (a compound in the citric acid cycle) across cell membranes, leading to metabolic dysfunction. E74.820 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, E74.820 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.
This is a highly specific code requiring genetic confirmation or clear clinical documentation of SLC13A5 deficiency. Because E74.820 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 E74.820 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a highly specific code requiring genetic confirmation or clear clinical documentation of SLC13A5 deficiency
- •Verify genetic testing results are documented in the medical record to support this diagnosis
Clinical Significance
SLC13A5 Citrate Transporter Disorder is an ultra-rare autosomal recessive neurometabolic condition caused by mutations in the SLC13A5 gene affecting citrate transport into cells. It presents with neonatal-onset seizures, severe developmental delay, and tooth enamel defects (amelogenesis imperfecta). The seizures are often treatment-resistant, and patients require complex multidisciplinary management.
Documentation Requirements
- ✓Confirmed diagnosis of SLC13A5 citrate transporter disorder
- ✓Genetic testing confirming biallelic SLC13A5 gene mutations
- ✓Documentation of neonatal seizure onset or early infantile epilepsy
- ✓Developmental assessment documenting delays
- ✓Dental findings including amelogenesis imperfecta if present
- ✓Current seizure management plan and response to treatment
Commonly Confused Codes
- •E74.829: Other disorders of citrate metabolism: for citrate metabolism disorders other than SLC13A5
- •E74.89: Other specified disorders of carbohydrate metabolism: broader category for unclassified carbohydrate disorders
- •G40.89: Other seizures: seizures are a manifestation, not the primary diagnosis
- •E74.810: Glucose transporter protein type 1 deficiency: different transporter and different clinical syndrome