E74.4 vs E88.4
E74.4 (Disorders of pyruvate metabolism and gluconeogenesis) compared with E88.4 (Mitochondrial metabolism disorders), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. E88.4 carries an Excludes1 note covering E74.4: “disorders of pyruvate metabolism (E74.4)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| E74.4Disorders of pyruvate metabolism and gluconeogenesis | E88.4Mitochondrial metabolism disorders | |
|---|---|---|
| Billing status | Billable | Non-billable header |
| Classification | E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89) | E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89) |
| Definition | Disorders of pyruvate metabolism and gluconeogenesis is a billable ICD-10-CM diagnosis code (E74.4). | Mitochondrial metabolism disorders is a non-billable ICD-10-CM category code (E88.4). |
| Includes | Deficiency of phosphoenolpyruvate carboxykinase Deficiency of pyruvate carboxylase Deficiency of pyruvate dehydrogenase | — |
| Use additional code | — | codes for associated conditions |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources