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E88.818 ICD-10-CM Code: Other insulin resistance

ICD-10-CM Code View

HCC Buddy Code Card

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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Metabolic disorders (E70-E88)

E88.818

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Other insulin resistance

Other forms of insulin resistance where the body's cells don't respond properly to insulin, not classified as Type A or unspecified.

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

Official
E88.8Other specified metabolic disorders
E88.81Metabolic syndrome and other insulin resistance
E88.818Other insulin resistance

Inclusion Terms

Official
  • Insulin resistance syndrome, Type B

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E88.818 in this effective period.

Related Child Codes

Official
E88.810Metabolic syndrome
E88.811Insulin resistance syndrome, Type A
E88.819Insulin resistance, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for E88.818 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for E88.818 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E88.818 in this effective period.

Use Additional

Official
  • codes for associated manifestations, such as:
  • obesity (E66.-)

Code Also

Official

ICD-10-CM does not list Code Also instructions for E88.818 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Use this code for insulin resistance that doesn't meet criteria for Type A but is more specific than unspecified
Document the clinical context and any associated metabolic abnormalities

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 E88.818 an HCC code?

No. E88.818 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Code
E88.818
Description
Other insulin resistance
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

E88.818 is the ICD-10-CM diagnosis code for other insulin resistance. Other forms of insulin resistance where the body's cells don't respond properly to insulin, not classified as Type A or unspecified. E88.818 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering metabolic disorders (e70-e88).

E88.818 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.

Use this code for insulin resistance that doesn't meet criteria for Type A but is more specific than unspecified.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E88.818 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code for insulin resistance that doesn't meet criteria for Type A but is more specific than unspecified
  • Document the clinical context and any associated metabolic abnormalities

Child Codes

Code Hierarchy

E88.818 code history

Code setChange
FY2024 (effective Oct 1, 2023)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Work E88.818 in HCC Buddy

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