D89.4 ICD-10-CM Code: Mast cell activation syndrome and related disorders
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for D89.4 in the official ICD-10-CM tabular list.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- defects in the complement system
- immunodeficiency disorders, except human immunodeficiency virus [HIV] disease
- sarcoidosis
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- aggressive systemic mastocytosis (C96.21) Compare D89.4 vs C96.21 →
- congenital cutaneous mastocytosis (Q82.2) Compare D89.4 vs Q82.2 →
- (non-congenital) cutaneous mastocytosis (D47.01) Compare D89.4 vs D47.01 →
- (indolent) systemic mastocytosis (D47.02) Compare D89.4 vs D47.02 →
- malignant mast cell neoplasm (C96.2-) Compare D89.4 vs C96.2 →
- malignant mastocytoma (C96.29) Compare D89.4 vs C96.29 →
- mast cell leukemia (C94.3-) Compare D89.4 vs C94.3 →
- mast cell sarcoma (C96.22) Compare D89.4 vs C96.22 →
- mastocytoma NOS (D47.09) Compare D89.4 vs D47.09 →
- other mast cell neoplasms of uncertain behavior (D47.09) Compare D89.4 vs D47.09 →
- systemic mastocytosis associated with a clonal hematologic non-mast cell lineage disease (SM-AHNMD) (D47.02) Compare D89.4 vs D47.02 →
- hyperglobulinemia NOS (R77.1) Compare D89.4 vs R77.1 →
- monoclonal gammopathy (of undetermined significance) (D47.2) Compare D89.4 vs D47.2 →
- autoimmune disease (systemic) NOS (M35.9) Compare D89.4 vs M35.9 →
- functional disorders of polymorphonuclear neutrophils (D71-) Compare D89.4 vs D71 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- transplant failure and rejection (T86.-) Compare D89.4 vs T86 →
- human immunodeficiency virus [HIV] disease (B20) Compare D89.4 vs B20 →
Frequently Compared Codes
The official Excludes notes on D89.4 name these codes. Each comparison page covers when the two can — or must not — be reported together.
Change history
- FY2027 — 2026-10-01Excludes2 note addedhuman immunodeficiency virus [HIV] disease (B20)FY2027 changes
- FY2027 — 2026-10-01Excludes1 note removedhuman immunodeficiency virus [HIV] disease (B20)FY2027 changes
- FY2017 — 2016-10-01Added to the code setMast cell activation syndrome and related disordersFY2017 changes
Verify Before Coding
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.
Contextual Map
Every relationship of D89.4 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Hierarchy
- D50-D89 — Chapter 3: Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89) (D50-D89) [Hierarchy]
- D80-D89 — Certain disorders involving the immune mechanism [Hierarchy]
Excludes1 (9)
- C94.3 — Mast cell leukemia [Excludes1]: “mast cell leukemia (C94.3-)” · check together
- C96.2 — Malignant mast cell neoplasm [Excludes1]: “malignant mast cell neoplasm (C96.2-)” · check together
- C96.21 — Aggressive systemic mastocytosis [Excludes1]: “aggressive systemic mastocytosis (C96.21)” · check together
- C96.22 — Mast cell sarcoma [Excludes1]: “mast cell sarcoma (C96.22)” · check together
- C96.29 — Other malignant mast cell neoplasm [Excludes1]: “malignant mastocytoma (C96.29)” · check together
- D47.01 — Cutaneous mastocytosis [Excludes1]: “(non-congenital) cutaneous mastocytosis (D47.01)” · check together
- D47.02 — Systemic mastocytosis [Excludes1]: “(indolent) systemic mastocytosis (D47.02)” · check together
- D47.09 — Other mast cell neoplasms of uncertain behavior [Excludes1]: “mastocytoma NOS (D47.09)” · check together
- and 1 more
Nearest codes (28)
- D89 — Other disorders involving the immune mechanism, not elsewhere classified [Sibling]
- D89.0 — Polyclonal hypergammaglobulinemia [Sibling]
- D89.1 — Cryoglobulinemia [Sibling]
- D89.2 — Hypergammaglobulinemia, unspecified [Sibling]
- D89.3 — Immune reconstitution syndrome [Sibling]
- D89.40 — Mast cell activation, unspecified [Sibling]
- D89.41 — Monoclonal mast cell activation syndrome [Sibling]
- D89.42 — Idiopathic mast cell activation syndrome [Sibling]
- and 20 more
Change history (3)
- FY2027 — Excludes2 note added [Change history]
- and 2 more
Frequently Asked Questions (FAQ) & Clinical Guidance
Can D89.4 be billed directly?
No. D89.4 (Mast cell activation syndrome and related disorders) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to D89.4 in its code family, with their registry titles.
- D89 — Other disorders involving the immune mechanism, not elsewhere classified
- D89.0 — Polyclonal hypergammaglobulinemia
- D89.1 — Cryoglobulinemia
- D89.2 — Hypergammaglobulinemia, unspecified
- D89.3 — Immune reconstitution syndrome
- D89.40 — Mast cell activation, unspecified
- D89.41 — Monoclonal mast cell activation syndrome
- D89.42 — Idiopathic mast cell activation syndrome
- D89.43 — Secondary mast cell activation
- D89.44 — Hereditary alpha tryptasemia