2026 ICD-10-CM Diagnosis Code E85.4Organ-limited amyloidosis

ICD-10-CM Codes›E00–E89›E70-E88›E85

ICD-10-CM E85.4
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

E85.4 is a billable ICD-10-CM diagnosis code for organ-limited amyloidosis. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 545 through 547. 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 10 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified and unspecified nutritional and metabolic disorders.

For Medicare Advantage risk adjustment, E85.4 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 2026.

Code Identity

ICD-10-CM Code
E85.4
Billable Status
Yes — Valid for Submission
Code Describes
Organ-limited amyloidosis
Short Description
Organ-limited amyloidosis
Same as the full description in the CMS dataset.
Parent Code
E85
Amyloidosis

Code Classification

ChapterE00–E89Endocrine, nutritional and metabolic diseases
SectionE70-E88Metabolic disorders
CategoryE85Amyloidosis
This CodeE85.4Organ-limited amyloidosis

Medicare Risk Adjustment (HCC)Billing

E85.4 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 2026.

CMS-HCC V28 Category (Payment Model)
HCC 50— Amyloidosis, Porphyria, and Other Specified Metabolic Disorders
Payment HCC · PY 2026 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HCC 50 is not superseded by any other condition category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)
Not mapped
E85.4 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2026 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.

  • Acquired abnormality of atrium
  • Age-related amyloidosis
  • Amyloid disease of the urethra
  • Amyloid nephropathy
  • Amyloid of cornea
  • Amyloid of prostate
  • Amyloid of testes
  • Amyloid of ureter
  • Amyloid of urinary bladder
  • Amyloid of vitreous
  • Amyloidosis cutis dyschromia
  • Amyloidosis limited to skin
  • Amyloidosis of skin
  • Amyloidosis of small intestine
  • Amyloidosis of spleen
  • Arthritis due to hemodialysis-associated amyloidosis
  • Arthritis secondary to amyloidosis
  • Autonomic neuropathy due to amyloidosis
  • Bullous cutaneous amyloidosis
  • Cardiac familial non-neuropathic amyloidosis
  • Cerebral amyloid angiopathy
  • Conjunctival amyloidosis
  • Danish type familial amyloid cardiomyopathy
  • Deposit on gingivae
  • Dominant primary localized cutaneous amyloidosis
  • Familial amyloid polyneuropathy
  • Familial amyloid polyneuropathy with cutaneous amyloidosis
  • Familial cardiomyopathy
  • Familial non-neuropathic amyloidosis
  • Gingival amyloidosis
  • Glomerular disorder due to amyloidosis
  • Glomerular disorder due to organ-limited amyloidosis
  • Hepatic amyloidosis
  • Hereditary cerebral amyloid angiopathy, Dutch type
  • Hereditary cerebral hemorrhage with amyloidosis
  • Hereditary cerebrovascular amyloidosis
  • Hereditary oculoleptomeningeal amyloid angiopathy
  • Heredofamilial systemic amyloidosis affecting skin
  • Infiltrative cardiomyopathy
  • Isolated atrial amyloid
  • Isolated corneal amyloidosis
  • Laryngeal amyloidosis
  • Lichen amyloidosis
  • Localized amyloidosis
  • Localized hereditary amyloidosis
  • Localized non-hereditary amyloidosis
  • Macroglossia due to amyloidosis
  • Macular cutaneous amyloidosis
  • Macule of skin
  • Neuropathy associated with dysproteinemias
  • Ocular amyloid deposit
  • Poikilodermal cutaneous amyloid
  • Primary localized cutaneous amyloidosis
  • Primary localized cutaneous nodular amyloidosis
  • Pulmonary amyloidosis
  • Secondary localized cutaneous amyloidosis
  • Senile brain amyloidosis
  • Senile cardiac amyloidosis
  • Sporadic cerebral amyloid angiopathy
  • Systemic amyloidosis affecting skin

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

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

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

  • Amyloid Neuropathies, Familial

    inherited disorders of the peripheral nervous system associated with the deposition of amyloid in nerve tissue. the different clinical types based on symptoms correspond to the presence of a variety of mutations in several different proteins including transthyretin (prealbumin); apolipoprotein a-i; and gelsolin.

  • Cerebral Amyloid Angiopathy

    a heterogeneous group of sporadic or familial disorders characterized by amyloid deposits in the walls of small and medium sized blood vessels of cerebral cortex and meninges. clinical features include multiple, small lobar cerebral hemorrhage; cerebral ischemia (brain ischemia); and cerebral infarction. cerebral amyloid angiopathy is unrelated to generalized amyloidosis. amyloidogenic peptides in this condition are nearly always the same ones found in alzheimer disease. (from kumar: robbins and cotran: pathologic basis of disease, 7th ed., 2005)

  • Cerebral Amyloid Angiopathy, Familial

    a familial disorder marked by amyloid deposits in the walls of small and medium sized blood vessels of cerebral cortex and meninges.

  • Cerebral Amyloid Angiopathy

    a disorder characterized by the deposition of amyloid in the wall of the vessels in the brain.

  • Cerebral Amyloid Angiopathy, APP-Related|HCHWAD|Hereditary Cerebral Hemorrhage with Amyloidosis-Dutch Type

    an autosomal dominant form of cerebral amyloid angiopathy caused by mutation(s) in the app gene, encoding amyloid-beta a4 protein. the deposition of amyloid in cerebral blood vessels wall may lead to degenerative vascular changes that may result in cerebral hemorrhage. mutation(s) in the app gene may also cause autosomal dominant alzheimer disease 1.

  • Myocardial Degeneration

    degeneration of myocardial tissue.

Patient EducationClinical

Amyloidosis

Amyloidosis occurs when abnormal proteins called amyloids build up and form deposits. The deposits can collect in organs such as the kidney and heart. This can cause the organs to become stiff and unable to work the way they should.

Read the full article at MedlinePlus

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

Convert E85.4 to ICD-9-CMHistory

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

ICD-9-CM
277.39 Amyloidosis NEC
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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About E85.4Overview

What is the ICD-10 code for organ-limited amyloidosis?

The ICD-10-CM code for organ-limited amyloidosis is E85.4 (sometimes written as E854). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is E85.4 (Amyloidosis) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report organ-limited amyloidosis on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does E85.4 group to?

When organ-limited amyloidosis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 545, 546, 547, with relative weights from 0.8362 to 2.4817 depending on complications. Higher weights mean higher Medicare reimbursement.

Is E85.4 a CC or MCC?

CMS lists E85.4 as a CC (complication or comorbidity) for FY 2026. 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 10 closely related codes in its exclusion list.

What is the ICD-9 equivalent of E85.4?

Under the General Equivalence Mappings, organ-limited amyloidosis converts to ICD-9-CM 277.39 (amyloidosis NEC). The mapping is approximate, so confirm the match fits the documentation.

What HCC is E85.4?

E85.4 (organ-limited amyloidosis) 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 2026. 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. It does not map to any RxHCC in the Part D prescription drug model.

Does E85.4 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, E85.4 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.