2026 ICD-10-CM Diagnosis Code E87.4Mixed disorder of acid-base balance

ICD-10-CM Codes›E00–E89›E70-E88›E87

ICD-10-CM E87.4
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

E87.4 is a billable ICD-10-CM diagnosis code for mixed disorder of acid-base balance. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 640 through 641. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fluid and electrolyte disorders.

Code Identity

ICD-10-CM Code
E87.4
Billable Status
Yes — Valid for Submission
Code Describes
Mixed disorder of acid-base balance
Short Description
Mixed disorder of acid-base balance
Same as the full description in the CMS dataset.
Parent Code
E87
Other disorders of fluid, electrolyte and acid-base balance

Code Classification

ChapterE00–E89Endocrine, nutritional and metabolic diseases
SectionE70-E88Metabolic disorders
CategoryE87Other disorders of fluid, electrolyte and acid-base balance
This CodeE87.4Mixed disorder of acid-base balance

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Abnormal acid-base balance
  • Abnormal acid-base balance affecting management of mother
  • Acid-base balance - finding
  • Base deficit
  • Base excess
  • Hypercapnia
  • Hypercapnia with mixed acid-base disorder
  • Metabolic acidosis and metabolic alkalosis
  • Mixed acid-base balance disorder
  • Mixed acid-base balance disorders - not compensated primary disorder
  • Respiratory acidosis and metabolic acidosis
  • Respiratory acidosis and metabolic alkalosis
  • Respiratory alkalosis and metabolic acidosis

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Abnormal, abnormality, abnormalities
      • acid-base balance (mixed)
    • Acidosis(lactic)
      • metabolic NEC
        • with respiratory acidosis
    • Acidosis(lactic)
      • respiratory
        • complicated by
          • metabolic
            • acidosis
    • Acidosis(lactic)
      • respiratory
        • complicated by
          • metabolic
            • alkalosis
    • Alkalosis
      • metabolic
        • with respiratory acidosis
    • Disorder(of)
      • balance
        • acid-base
          • mixed
    • Disturbance(s)
      • acid-base equilibrium
        • mixed

Clinical ClassificationClinical

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

CCSR END011
Fluid and electrolyte disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Hypercapnia

    a clinical manifestation of abnormal increase in the amount of carbon dioxide in arterial blood.

Patient EducationClinical

Fluid and Electrolyte Balance

Electrolytes are minerals that have an electric charge when they are dissolved in water or body fluids, including blood. The electric charge can be positive or negative. You have electrolytes in your blood, urine (pee), tissues, and other body fluids.

The full article covers:

  • What are electrolytes?
  • What are the different types of electrolytes in your body?
  • What is an electrolyte imbalance?
  • What are the different types of electrolyte imbalances?
  • How are electrolyte imbalances diagnosed?
  • What are the treatments for electrolyte imbalances?

Read the full article at MedlinePlus

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

Convert E87.4 to ICD-9-CMHistory

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

ICD-9-CM
276.4 Mixed acid-base bal dis
Exact Match The mapping is direct, with no qualifiers.

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 E87.4Overview

Is E87.4 (Other disorders of fluid, electrolyte and acid-base balance) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report mixed disorder of acid-base balance on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does E87.4 group to?

When mixed disorder of acid-base balance is the principal diagnosis on an inpatient stay, it groups to MS-DRG 640, 641, with relative weights from 0.7782 to 1.3356 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of E87.4?

Under the General Equivalence Mappings, mixed disorder of acid-base balance converts to ICD-9-CM 276.4 (mixed acid-base bal dis). The mapping is a direct match.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.