E76.9 ICD-10-CM Code: Glucosaminoglycan metabolism disorder, unspecified
HCC Buddy Code Card
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Metabolic disorders (E70-E88)
E76.9
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceGlucosaminoglycan metabolism disorder, unspecified
Glucosaminoglycan metabolism disorder, unspecified, is used when a patient has a disorder affecting how the body processes complex sugars but the specific type cannot be identified.
Buddy Insight
Glucosaminoglycan metabolism disorder, unspecified is used when abnormal GAG metabolism is confirmed but the specific disorder has not been identified.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
MappedHCC 23
RAF 0.230
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 23
RAF 0.0
RXHCC
MappedHCC 43
RAF 0.0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for E76.9 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E76.9 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for E76.9 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for E76.9 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E76.9 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for E76.9 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for E76.9 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 E76.9 an HCC code?
Yes. E76.9 maps to Other Significant Endocrine and Metabolic Disorders under the V24 model but is not retained in V28.
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 E76.9
For E76.9to 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 E76.9 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
E76.9 is the ICD-10-CM diagnosis code for glucosaminoglycan metabolism disorder, unspecified. Glucosaminoglycan metabolism disorder, unspecified, is used when a patient has a disorder affecting how the body processes complex sugars but the specific type cannot be identified. E76.9 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, E76.9 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.
This is the least specific code in the glucosaminoglycan metabolism category; pursue additional diagnostic information when possible. Because E76.9 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 E76.9 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 code in the glucosaminoglycan metabolism category; pursue additional diagnostic information when possible
- •Use only when no more specific diagnosis code can be determined from the clinical documentation
Clinical Significance
Glucosaminoglycan metabolism disorder, unspecified is used when abnormal GAG metabolism is confirmed but the specific disorder has not been identified. This is a broad code that may capture early diagnostic evaluations for suspected MPS or other GAG disorders before definitive testing is complete.
Documentation Requirements
- ✓Provider documentation of confirmed or suspected GAG metabolism disorder
- ✓Supporting clinical or laboratory evidence (elevated urine GAGs, clinical features suggestive of storage disorder)
- ✓Reason for lack of specificity (evaluation in progress, atypical results)
- ✓Plan for further diagnostic evaluation
- ✓Current symptom management
Commonly Confused Codes
- •E76.3 — Mucopolysaccharidosis, unspecified: more specific than E76.9 when MPS IS confirmed but type unknown
- •E76.8 — Other disorders of glucosaminoglycan metabolism: for identified non-MPS GAG disorders
- •E88.9 — Metabolic disorder, unspecified: even broader and should not be used when GAG involvement is known
- •E76.01-E76.29 — Specific MPS types: use whenever the type is identified