2026 ICD-10-CM Diagnosis Code E85.9Amyloidosis, unspecified
ICD-10-CM Codes›E00–E89›E70-E88›E85
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 50
- Chronic Condition
E85.9 is a billable ICD-10-CM diagnosis code for amyloidosis, unspecified. 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, E85.9 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
Code Classification
Medicare Risk Adjustment (HCC)Billing
E85.9 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.
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.
- Amyloid myopathy
- Amyloid nephropathy
- Amyloidosis
- Dilated cardiomyopathy due to amyloidosis
- Dilated cardiomyopathy due to infiltration
- Entrapment syndrome due to amyloid
- Factor X deficiency
- Factor X deficiency due to systemic amyloidosis
- Glomerular disorder due to amyloidosis
- Hypothyroidism due to amyloidosis
- Hypothyroidism due to infiltrative disease
- Infiltrative cardiomyopathy
- Nephrotic syndrome in amyloidosis
- Prothrombin complex deficiency
- Restrictive cardiomyopathy secondary to amyloidosis
- Secondary restrictive cardiomyopathy
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
amyloid See Also: Amyloidosis; E85.9
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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.Amyloidosis
a group of sporadic, familial and/or inherited, degenerative, and infectious disease processes, linked by the common theme of abnormal protein folding and deposition of amyloid. as the amyloid deposits enlarge they displace normal tissue structures, causing disruption of function. various signs and symptoms depend on the location and size of the deposits.Amyloidosis, Familial
diseases in which there is a familial pattern of amyloidosis.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.Immunoglobulin Light-chain Amyloidosis
a nonproliferative disorder of plasma cells characterized by excessive production and misfolding of immunoglobulin light chains that form insoluble amyloid fibrils (see amyloid deposits) in various tissues. clinical features include liver failure; multiple myeloma; nephrotic syndrome; restrictive cardiomyopathy, and neuropathies.Factor X Deficiency
blood coagulation disorder usually inherited as an autosomal recessive trait, though it can be acquired. it is characterized by defective activity in both the intrinsic and extrinsic pathways, impaired thromboplastin time, and impaired prothrombin consumption.Amyloid
a fibrous protein complex that consists of proteins folded into a specific cross beta-pleated sheet structure. this fibrillar structure has been found as an alternative folding pattern for a variety of functional proteins. deposits of amyloid in the form of amyloid plaques are associated with a variety of degenerative diseases. the amyloid structure has also been found in a number of functional proteins that are unrelated to disease.Myocardial Degeneration
degeneration of myocardial tissue.Acquired Factor X Deficiency
an acquired coagulation disorder characterized by the partial or complete absence of factor x activity in the blood.Factor X Deficiency
a coagulation disorder characterized by the partial or complete absence of factor x activity in the blood.Hereditary Factor X Deficiency|Stuart-Prower Factor Deficiency
a rare autosomal recessive inherited blood coagulation disorder characterized by deficiency of factor x, resulting in bleeding.
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 E85.9 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About E85.9Overview
What is the ICD-10 code for amyloidosis, unspecified?
The ICD-10-CM code for amyloidosis, unspecified is E85.9 (sometimes written as E859). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is E85.9 (Amyloidosis) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report amyloidosis, unspecified on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does E85.9 group to?
When amyloidosis, unspecified 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 E85.9 a CC or MCC?
CMS lists E85.9 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 E85.9?
Under the General Equivalence Mappings, amyloidosis, unspecified converts to ICD-9-CM 277.30 (amyloidosis NOS). The mapping is approximate, so confirm the match fits the documentation.
What HCC is E85.9?
E85.9 (amyloidosis, unspecified) 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 E85.9 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, E85.9 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.
