E83.09
BillableOther disorders of copper metabolism
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E83.09 an HCC code?
Yes. E83.09 maps to Glycogen/Amino-Acid/Other Metabolic Disorders under the CMS-HCC V28 risk adjustment model.
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 E83.09
For E83.09 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 E83.09 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E83.09 is the ICD-10-CM diagnosis code for other disorders of copper metabolism. Rare inherited or acquired conditions affecting copper metabolism in the body, other than Wilson's disease. E83.09 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 CMS-HCC V28 risk adjustment model, E83.09 maps to Glycogen/Amino-Acid/Other Metabolic Disorders (HCC 50) with a community, non-dual, aged base RAF weight of 0.289. E83.09 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. 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.
Document the specific type of copper metabolism disorder when possible to support medical necessity. Because E83.09 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 E83.09 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific type of copper metabolism disorder when possible to support medical necessity
- •Distinguish from Wilson's disease and unspecified copper metabolism disorders
Clinical Significance
Other disorders of copper metabolism captures copper metabolism conditions other than Wilson disease, including Menkes disease (kinky hair syndrome), occipital horn syndrome, and copper-associated conditions not elsewhere classified. Menkes disease, caused by ATP7A mutations, results in copper deficiency in tissues and is a severe X-linked neurodegenerative disorder.
Documentation Requirements
- ✓Specific copper metabolism disorder documented (e.g., Menkes disease, occipital horn syndrome)
- ✓Confirmatory testing: serum copper and ceruloplasmin (both LOW in Menkes), genetic testing (ATP7A mutations)
- ✓Clinical manifestations: kinky hair, seizures, failure to thrive, connective tissue abnormalities (Menkes)
- ✓Differentiation from Wilson disease (copper excess) vs. Menkes (copper deficiency in tissues)
- ✓Treatment plan: subcutaneous copper histidine injections (Menkes), supportive care
Commonly Confused Codes
- •E83.01 — Wilson's disease: copper EXCESS disorder; Menkes is copper DEFICIENCY in tissues
- •E83.00 — Disorder of copper metabolism, unspecified: use only when the specific disorder is unknown
- •E61.0 — Copper deficiency: nutritional copper deficiency, not genetic copper metabolism disorder
- •Q84.1 — Congenital morphological disturbances of hair, not elsewhere classified: kinky hair in Menkes requires the metabolic code