E75.6
BillableLipid storage disorder, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E75.6 an HCC code?
No. E75.6 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
HCC Category Mapping
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 E75.6
For E75.6 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 E75.6 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E75.6 is the ICD-10-CM diagnosis code for lipid storage disorder, unspecified. A general category for inherited metabolic disorders involving abnormal accumulation of fatty substances when the specific type cannot be identified. E75.6 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering metabolic disorders (e70-e88).
E75.6 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
E75.6 maps only to RxHCC 43 (Inflammatory Bowel Disease) with no RAF weight. It has no mapping in V24 or V28 CMS-HCC models, meaning it does not impact Medicare Advantage RAF scores. Coders should seek greater specificity not only for clinical accuracy but because more specific codes like E75.3 do carry V24 HCC value.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E75.6 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is the least specific lipid storage disorder code; use only when no other E75 code applies
- •Query provider for additional diagnostic information to assign a more specific code
Clinical Significance
Lipid storage disorder, unspecified is used when a provider has confirmed a lipid storage disorder but the specific type has not been identified or documented. This nonspecific code signals that further diagnostic workup may be needed to identify the exact lysosomal storage disease for appropriate treatment planning.
Documentation Requirements
- ✓Provider statement confirming a lipid storage disorder diagnosis
- ✓Clinical findings suggestive of lipid accumulation (hepatosplenomegaly, neurological decline, biopsy findings)
- ✓Diagnostic workup performed or planned (enzyme studies, genetic panels)
- ✓Reason the specific type is unknown (pending results, inconclusive testing, atypical presentation)
- ✓Current symptoms and management plan
Commonly Confused Codes
- •E75.5 — Other lipid storage disorders: use when the type is known but does not have a specific code
- •E75.3 — Sphingolipidosis, unspecified: more specific than E75.6 if sphingolipid involvement is confirmed
- •E78.9 — Disorder of lipoprotein metabolism, unspecified: for circulating lipid abnormalities, NOT intracellular storage
- •E88.9 — Metabolic disorder, unspecified: too broad; use E75.6 when lipid storage is confirmed