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ICD-10-CM E85.4: Organ-limited amyloidosis

E85.4 is the billable ICD-10-CM code for organ-limited amyloidosis, in category E85 (Amyloidosis) of the Metabolic disorders section. As a principal diagnosis it groups to MS-DRG 545 Connective Tissue Disorders with MCC, MS-DRG 546 Connective Tissue Disorders with CC, MS-DRG 547 Connective Tissue Disorders without CC/MCC (MDC 08 MDC 08: Diseases and Disorders of the Musculoskeletal System and Connective Tissue). It maps to HCC 50 (Amyloidosis, Porphyria, and Other Specified Metabolic Disorders) in CMS-HCC V28. As a secondary diagnosis it is a CC, excluded with 10 principal diagnoses. 29 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
E85.4
billable FY2027 ICD-10-CM code
Category
E85 Amyloidosis
Chapter
4: Endocrine, nutritional and metabolic diseases (E00-E89)
CC/MCC (MS-DRG v44)
CC
CMS-HCC V28
HCC 50
POA reporting
Required

Tabular list notes for E85.4

Inclusion terms
  • Localized amyloidosis
  • Transthyretin-related (ATTR) familial amyloid cardiomyopathy

Inherited from E85 (Amyloidosis)

Excludes2 (not part of this condition, may be coded together)
  • Alzheimer's disease (G30.0-)

MS-DRG grouping when E85.4 is the principal diagnosis

MS-DRG v44 groups for E85.4 as principal diagnosis
MDCMS-DRGs
08 MDC 08: Diseases and Disorders of the Musculoskeletal System and Connective Tissue545546547

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for E85.4 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, E85.4 is a CC under MS-DRG v44, unless the principal diagnosis is one of the 10 codes in its exclusion list. Check E85.4 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.

CMS-HCC V28 risk adjustment

In the PY2027 mapping, E85.4 maps to HCC 50 (Amyloidosis, Porphyria, and Other Specified Metabolic Disorders). The HCC lookup shows the RAF weight and the hierarchy.

LCD billing and coding articles that list E85.4

29 current Medicare billing and coding articles list E85.4 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM E85.4 mean?

E85.4 means organ-limited amyloidosis. The tabular list also files these terms under it: Localized amyloidosis; Transthyretin-related (ATTR) familial amyloid cardiomyopathy. It is one of 9 billable codes under E85, amyloidosis.

Which MS-DRG does E85.4 group to?

As the principal diagnosis, E85.4 groups to MS-DRG 545 Connective Tissue Disorders with MCC, MS-DRG 546 Connective Tissue Disorders with CC, MS-DRG 547 Connective Tissue Disorders without CC/MCC (MDC 08 MDC 08: Diseases and Disorders of the Musculoskeletal System and Connective Tissue) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Does E85.4 map to an HCC?

Yes: HCC 50, Amyloidosis, Porphyria, and Other Specified Metabolic Disorders, in the PY2027 CMS-HCC V28 mapping.

Is E85.4 a CC or MCC?

E85.4 is a CC under MS-DRG v44; 10 principal diagnoses exclude it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.