2027 ICD-10-CM Diagnosis Code E80.21Acute intermittent (hepatic) porphyria

ICD-10-CM Codes›E00–E89›E70-E88›E80

ICD-10-CM E80.21
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

E80.21 is a billable ICD-10-CM diagnosis code for acute intermittent (hepatic) porphyria. 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. Coders also document this condition as acute intermittent porphyria. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified and unspecified nutritional and metabolic disorders.

For Medicare Advantage risk adjustment, E80.21 maps to CMS-HCC Category 50 (Amyloidosis, Porphyria, and Other Specified Metabolic Disorders) under the V28 model, adding a risk factor of about 0.648 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
E80.21
Billable Status
Yes — Valid for Submission
Code Describes
Acute intermittent (hepatic) porphyria
Short Description
Acute intermittent (hepatic) porphyria
Same as the full description in the CMS dataset.
Parent Code
Other and unspecified porphyria

Code Classification

ChapterE00–E89Endocrine, nutritional and metabolic diseases
SectionE70-E88Metabolic disorders
CategoryE80Disorders of porphyrin and bilirubin metabolism
This CodeE80.21Acute intermittent (hepatic) porphyria

Medicare Risk Adjustment (HCC)Billing

E80.21 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 50— Amyloidosis, Porphyria, and Other Specified Metabolic Disorders
Payment HCC · PY 2027 one of 32 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.648
community, non-dual, aged · ranges 0.362–0.883 across segments
Hierarchy
Top of its hierarchy
HCC 50 is not superseded by any other condition category
Prior Model (CMS-HCC V24)
HCC 23
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 23 · ESRD (V21): HCC 23 · ESRD (V24): HCC 23
ESRD V21 weights: 0.013 dialysis, 0.234–0.359 functioning graft · ESRD V24 weights: 0.036 dialysis, 0.217–0.390 functioning graft
Part D (RxHCC)
RxHCC 43 — Pituitary, Adrenal Gland, and Other Endocrine and Metabolic 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.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Acute intermittent porphyria
  • Homozygous acute intermittent porphyria
  • Porphobilinogen deaminase deficiency

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to E80.21: its own notes plus those printed at E80, block E70-E88, and Chapter 4. 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 E80 Disorders of porphyrin and bilirubin metabolism applies to 10 codes
  • defects of catalase and peroxidase

Excludes1

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

From Block E70-E88 Metabolic disorders applies to 286 codes
  • androgen insensitivity syndrome (E34.5-)
  • congenital adrenal hyperplasia (E25.0)
  • hemolytic anemias attributable to enzyme disorders (D55.-)
  • Marfan syndrome (Q87.4-)
  • 5-alpha-reductase deficiency (E29.1)
From Chapter 4 (E00-E89) Endocrine, nutritional and metabolic diseases applies to 973 codes
  • transitory endocrine and metabolic disorders specific to newborn (P70-P74)

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 E70-E88 Metabolic disorders applies to 286 codes
  • Ehlers-Danlos syndromes (Q79.6-)

Notes

General instructions on how these codes are used.

From Chapter 4 (E00-E89) Endocrine, nutritional and metabolic diseases applies to 973 codes
  • 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.

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

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

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

CCSR END016
Other specified and unspecified nutritional and metabolic disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Porphyria, Acute Intermittent

    an autosomal dominant porphyria that is due to a deficiency of hydroxymethylbilane synthase in the liver, the third enzyme in the 8-enzyme biosynthetic pathway of heme. clinical features are recurrent and life-threatening neurologic disturbances, abdominal pain, and elevated level of aminolevulinic acid and porphobilinogen in the urine.

Patient EducationClinical

Porphyria

Porphyrias are a group of genetic disorders caused by problems with how your body makes a substance called heme. Heme is found throughout the body, especially in your blood and bone marrow, where it carries oxygen.

Read the full article at MedlinePlus

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

Convert E80.21 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
277.1 Dis porphyrin metabolism
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About E80.21Overview

What is the ICD-10 code for acute intermittent (hepatic) porphyria?

The ICD-10-CM code for acute intermittent (hepatic) porphyria is E80.21 (sometimes written as E8021). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is E80.21 (Other and unspecified porphyria) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report acute intermittent (hepatic) porphyria on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does E80.21 group to?

When acute intermittent (hepatic) porphyria 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 E80.21 a CC or MCC?

CMS lists E80.21 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 E80.21 be reported with a code from E34.5?

Not as a rule. The Excludes1 note at block E70-E88, which applies to E80.21, lists "androgen insensitivity syndrome (E34.5-)". 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 E80.21?

E80.21 (acute intermittent (hepatic) porphyria) maps to CMS-HCC Category 50 (Amyloidosis, Porphyria, and Other Specified Metabolic Disorders), commonly written as HCC 50, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 23 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 43.

Does E80.21 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, E80.21 adds a risk adjustment factor of about 0.648 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.362 to 0.883 depending on the payment segment). HCC 50 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 50 category page.