Question 1

What is ICD-10 code E85?

Accepted Answer

E85 is the ICD-10-CM diagnosis code for amyloidosis. E85 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering metabolic disorders (e70-e88).

E85 is a non-billable category for amyloidosis. Move through the official child-code path until the documented detail supports a reportable code.

Question 2

Is E85 an HCC code?

Accepted Answer

E85 is a non-billable header code, so it cannot itself be a payment HCC. Header codes organize more specific child codes that share the same root concept; one of those children may map to a payment HCC under the CMS-HCC V28 or V24 risk adjustment model. Coders should select a child code from the E85 hierarchy that matches the documented presentation, then check that specific child for HCC status.

Question 3

Is E85 billable?

Accepted Answer

No. E85 is a header (non-billable) ICD-10-CM code. Header codes sit at a higher level of the diagnosis hierarchy and exist to organize a family of more specific child codes. Per ICD-10-CM coding guidelines, a header code cannot be reported on a claim as the diagnosis, coders must select a billable child code from the E85 hierarchy that matches the highest level of specificity supported by the provider's documentation. Payers reject header codes submitted as the primary diagnosis.

Question 4

What should coders know when reporting E85?

Accepted Answer

E85 is a non-billable category for amyloidosis. Move through the official child-code path until the documented detail supports a reportable code. For this DOS, capture the provider's current assessment and the care action documented for amyloidosis. Keep the checklist tied to the note. Do not swap E85 with E85.0. The FY2026 tabular describes E85.0 as non-neuropathic heredofamilial amyloidosis. Follow the documented detail.

HCC Buddy Code Card

E85

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What This Code Means

Coding Tips

Excludes 2, Not included here, may code separately

Child Codes

Code Hierarchy

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E85 ICD-10-CM Code: Amyloidosis