E88.811 ICD-10-CM Code: Insulin resistance syndrome, Type A
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Metabolic disorders (E70-E88)
E88.811
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceInsulin resistance syndrome, Type A
Insulin resistance syndrome Type A is a condition where the body's cells don't respond properly to insulin, often associated with obesity and metabolic complications.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for E88.811 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E88.811 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for E88.811 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for E88.811 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E88.811 in this effective period.
Use Additional
Official- codes for associated manifestations, such as:
- obesity (E66.-)
Code Also
OfficialICD-10-CM does not list Code Also instructions for E88.811 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is E88.811 an HCC code?
No. E88.811 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- E88.811
- Description
- Insulin resistance syndrome, Type A
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
E88.811 is the ICD-10-CM diagnosis code for insulin resistance syndrome, type a. Insulin resistance syndrome Type A is a condition where the body's cells don't respond properly to insulin, often associated with obesity and metabolic complications. E88.811 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering metabolic disorders (e70-e88).
E88.811 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.
Type A insulin resistance is typically associated with severe insulin resistance and acanthosis nigricans; document associated findings.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E88.811 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Type A insulin resistance is typically associated with severe insulin resistance and acanthosis nigricans; document associated findings
- •Differentiate between Type A and other insulin resistance types (E88.818) based on clinical presentation and diagnostic criteria