2027 ICD-10-CM Diagnosis Code D81.39Other adenosine deaminase deficiency

ICD-10-CM Codes›D50–D89›D80-D89›D81

ICD-10-CM D81.39
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

D81.39 is a billable ICD-10-CM diagnosis code for other adenosine deaminase deficiency. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 642. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 35 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Immunity disorders and Other specified and unspecified nutritional and metabolic disorders.

For Medicare Advantage risk adjustment, D81.39 maps to CMS-HCC Category 114 (Common Variable and Combined Immunodeficiencies) under the V28 model, adding a risk factor of about 2.262 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
D81.39
Billable Status
Yes — Valid for Submission
Code Describes
Other adenosine deaminase deficiency
Short Description
Other adenosine deaminase deficiency
Same as the full description in the CMS dataset.
Parent Code
Adenosine deaminase [ADA] deficiency

Code Classification

ChapterD50–D89Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
SectionD80-D89Certain disorders involving the immune mechanism
CategoryD81Combined immunodeficiencies
This CodeD81.39Other adenosine deaminase deficiency

Medicare Risk Adjustment (HCC)Billing

D81.39 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 114— Common Variable and Combined Immunodeficiencies
Payment HCC · PY 2027 one of 18 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+2.262
community, non-dual, aged · ranges 0.691–2.789 across segments
Hierarchy
Supersedes HCC 115
less severe related categories are not paid alongside HCC 114
Prior Model (CMS-HCC V24)
HCC 47
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 47 · ESRD (V21): HCC 47 · ESRD (V24): HCC 47
ESRD V21 weights: 0.097 dialysis, 0.549–0.688 functioning graft · ESRD V24 weights: 0.078 dialysis, 0.523–0.803 functioning graft
Part D (RxHCC)
RxHCC 99 — Immune Disorders
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to D81.39: its own notes plus those printed at D81, block D80-D89, and Chapter 3. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Block D80-D89 Certain disorders involving the immune mechanism applies to 83 codes
  • defects in the complement system
  • immunodeficiency disorders, except human immunodeficiency virus [HIV] disease
  • sarcoidosis

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Adenosine deaminase [ADA] deficiency type 1, NOS
  • Adenosine deaminase [ADA] deficiency type 1, without SCID
  • Adenosine deaminase [ADA] deficiency type 1, without severe combined immunodeficiency
  • Partial ADA deficiency (type 1)
  • Partial adenosine deaminase deficiency (type 1)

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From D81 Combined immunodeficiencies applies to 17 codes
  • autosomal recessive agammaglobulinemia (Swiss type) (D80.0)
From Block D80-D89 Certain disorders involving the immune mechanism applies to 83 codes
  • autoimmune disease (systemic) NOS (M35.9)
  • functional disorders of polymorphonuclear neutrophils (D71-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Block D80-D89 Certain disorders involving the immune mechanism applies to 83 codes
  • human immunodeficiency virus [HIV] disease (B20)
From Chapter 3 (D50-D89) Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism applies to 324 codes
  • autoimmune disease (systemic) NOS (M35.9)
  • certain conditions originating in the perinatal period (P00-P96)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • human immunodeficiency virus [HIV] disease (B20)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name D81.39, its category, or a range that includes it.

Excludes1 3

These codes carry an Excludes1 note naming D81.39: they are not reported together with it, unless the two conditions are unrelated.

  • E79 Disorders of purine and pyrimidine metabolism
    combined immunodeficiency disorders (D81.-) names D81.-, which includes this code
  • D72 Other disorders of white blood cells
    immunity disorders (D80-D89) names D80-D89, which includes this code
  • D84.81 Immunodeficiency due to conditions classified elsewhere
    certain disorders involving the immune mechanism (D80-D83, D84.0, D84.1, D84.9) names D80-D83, which includes this code

Index to Diseases and InjuriesGuidance

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR BLD008
Immunity disorders
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR END016
Other specified and unspecified nutritional and metabolic disorders
Default principal diagnosis: inpatient No · outpatient No

Patient EducationClinical

Adenosine deaminase deficiency

Adenosine deaminase (ADA) deficiency is a disorder that affects the immune system. Specifically, ADA deficiency impairs the development and function of immune cells called lymphocytes. Lymphocytes are white blood cells that help the body fight infections.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Code History & ChangesHistory

Replacement D81.39 replaces the following previously assigned code(s):

  • D81.3 - Adenosine deaminase [ADA] deficiency
FY 2020AddedAdded to the ICD-10-CM code setEffective October 1, 2019.
FY 2021–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About D81.39Overview

What is the ICD-10 code for other adenosine deaminase deficiency?

The ICD-10-CM code for other adenosine deaminase deficiency is D81.39 (sometimes written as D8139). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is D81.39 (Adenosine deaminase [ADA] deficiency) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report other adenosine deaminase deficiency on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does D81.39 group to?

When other adenosine deaminase deficiency is the principal diagnosis on an inpatient stay, it groups to MS-DRG 642 (inborn and Other Disorders of Metabolism), which carries a relative weight of 1.3226. Higher weights mean higher Medicare reimbursement.

Is D81.39 a CC or MCC?

CMS lists D81.39 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 35 closely related codes in its exclusion list.

Can D81.39 be reported with D80.0?

Not as a rule. The Excludes1 note at D81, which applies to D81.39, lists "autosomal recessive agammaglobulinemia (Swiss type) (D80.0)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What HCC is D81.39?

D81.39 (other adenosine deaminase deficiency) maps to CMS-HCC Category 114 (Common Variable and Combined Immunodeficiencies), commonly written as HCC 114, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 47 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 99.

Does D81.39 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, D81.39 adds a risk adjustment factor of about 2.262 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.691 to 2.789 depending on the payment segment). HCC 114 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 114 category page.