2019 ICD-10-CM Diagnosis Code E88.81

Metabolic syndrome

    2016 2017 2018 2019 Billable/Specific Code
  • E88.81 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2019 edition of ICD-10-CM E88.81 became effective on October 1, 2018.
  • This is the American ICD-10-CM version of E88.81 - other international versions of ICD-10 E88.81 may differ.
Applicable To
  • Dysmetabolic syndrome X
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Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • codes for associated manifestations, such as:
  • obesity (
    ICD-10-CM Diagnosis Code E66
    • E66 Overweight and obesity
      • E66.0 Obesity due to excess calories
        • E66.01 Morbid (severe) obesity due to excess calorie...
        • E66.09 Other obesity due to excess calories
      • E66.1 Drug-induced obesity
      • E66.2 Morbid (severe) obesity with alveolar hypoven...
      • E66.3 Overweight
      • E66.8 Other obesity
      • E66.9 Obesity, unspecified
    E66.-
    )
The following code(s) above E88.81 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to E88.81:
  • E00-E89
    2019 ICD-10-CM Range E00-E89

    Endocrine, nutritional and metabolic diseases

    Note
    • All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.
    Type 1 Excludes
    • transitory endocrine and metabolic disorders specific to newborn (P70-P74)
    Endocrine, nutritional and metabolic diseases
  • E70-E88
    2019 ICD-10-CM Range E70-E88

    Metabolic disorders

    Type 1 Excludes
    • androgen insensitivity syndrome (E34.5-)
    • congenital adrenal hyperplasia (E25.0)
    • Ehlers-Danlos syndrome (Q79.6)
    • hemolytic anemias attributable to enzyme disorders (D55.-)
    • Marfan's syndrome (Q87.4)
    • 5-alpha-reductase deficiency (E29.1)
    Metabolic disorders
  • E88
    ICD-10-CM Diagnosis Code E88

    Other and unspecified metabolic disorders

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Type 1 Excludes
    • histiocytosis X (chronic) (C96.6)
    Use Additional
    • codes for associated conditions
    Other and unspecified metabolic disorders
Approximate Synonyms
  • Drug resistance to insulin
  • Dysmetabolic syndrome x
  • Insulin resistance
  • Metabolic syndrome x
Clinical Information
  • A cluster of metabolic risk factors for cardiovascular diseases and type 2 diabetes mellitus. The major components of metabolic syndrome x include excess abdominal fat; atherogenic dyslipidemia; hypertension; hyperglycemia; insulin resistance; a proinflammatory state; and a prothrombotic (thrombosis) state. (from aha/nhlbi/ada conference proceedings, circulation 2004; 109:551-556)
  • A collection of metabolic risk factors in one individual. The root causes of metabolic syndrome are overweight / obesity, physical inactivity, and genetic factors. Various risk factors have been included in metabolic syndrome. Factors generally accepted as being characteristic of this syndrome include abdominal obesity, atherogenic dyslipidemia, raised blood pressure, insulin resistence with or without glucose intolerance, prothrombotic state, and proinflammatory state.
  • A condition is marked by extra fat around the abdomen, high levels of blood glucose (sugar) when not eating, high levels of triglycerides (a type of fat) in the blood, low levels of high-density lipoproteins (a type of protein that carries fats) in the blood, and high blood pressure. People with metabolic syndrome are at increased risk of diabetes mellitus and diseases of the heart and blood vessels.
  • A multifaceted syndrome characterized by clustering of insulin resistance and hyperinsulinemia, associated with dyslipidemia, essential hypertension, abdominal obesity, glucose intolerance or noninsulin dependent diabetes mellitus, and an increased risk of cardiovascular events.
  • A term referring to a combination of medical conditions that, when present, increase the risk of heart attack, stroke, and diabetes mellitus. It includes the following medical conditions: increased blood pressure, central obesity, abnormal cholesterol levels, and elevated fasting glucose.
  • Metabolic syndrome is a group of conditions that put you at risk for heart disease and diabetes. These conditions are
    • high blood pressure
    • high blood sugar levels
    • high levels of triglycerides, a type of fat, in your blood
    • low levels of hdl, the good cholesterol, in your blood
    • too much fat around your waist
    not all doctors agree on the definition or cause of metabolic syndrome. The cause might be insulin resistance. Insulin is a hormone your body produces to help you turn sugar from food into energy for your body. If you are insulin resistant, too much sugar builds up in your blood, setting the stage for disease.
ICD-10-CM E88.81 is grouped within Diagnostic Related Group(s) (MS-DRG v36.0):
  • 642 Inborn and other disorders of metabolism

Convert E88.81 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
Code annotations containing back-references to E88.81:
  • Type 1 Excludes: R73.0
    ICD-10-CM Diagnosis Code R73.0

    Abnormal glucose

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Type 1 Excludes

Diagnosis Index entries containing back-references to E88.81:
  • Dysmetabolic syndrome X E88.81
  • Metabolic syndrome E88.81
  • Resistance, resistant (to)
    • insulin E88.81
  • Syndrome - see also Disease
    • dysmetabolic X E88.81
    • metabolic E88.81

ICD-10-CM Codes Adjacent To E88.81
E88.09 Other disorders of plasma-protein metabolism, not elsewhere classified
E88.1 Lipodystrophy, not elsewhere classified
E88.2 Lipomatosis, not elsewhere classified
E88.3 Tumor lysis syndrome
E88.4 Mitochondrial metabolism disorders
E88.40 Mitochondrial metabolism disorder, unspecified
E88.41 MELAS syndrome
E88.42 MERRF syndrome
E88.49 Other mitochondrial metabolism disorders
E88.8 Other specified metabolic disorders
E88.81 Metabolic syndrome
E88.89 Other specified metabolic disorders
E88.9 Metabolic disorder, unspecified
E89 Postprocedural endocrine and metabolic complications and disorders, not elsewhere classified
E89.0 Postprocedural hypothyroidism
E89.1 Postprocedural hypoinsulinemia
E89.2 Postprocedural hypoparathyroidism
E89.3 Postprocedural hypopituitarism
E89.4 Postprocedural ovarian failure
E89.40 Asymptomatic postprocedural ovarian failure
E89.41 Symptomatic postprocedural ovarian failure

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.