D89.41 ICD-10-CM Code: Monoclonal mast cell activation syndrome
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Inpatient Payment Groups (MS-DRG)
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.
- MS-DRG 814 — RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC (MDC 16)
- MS-DRG 815 — RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC (MDC 16)
- MS-DRG 816 — RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC (MDC 16)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Code Overview
Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for D89.41 in the official ICD-10-CM tabular list.
This page already reflects the FY2027 tabular note taking effect October 1, 2026.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
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) inherited from D89.4Compare D89.41 vs C96.21 →
- congenital cutaneous mastocytosis (Q82.2) inherited from D89.4Compare D89.41 vs Q82.2 →
- (non-congenital) cutaneous mastocytosis (D47.01) inherited from D89.4Compare D89.41 vs D47.01 →
- (indolent) systemic mastocytosis (D47.02) inherited from D89.4Compare D89.41 vs D47.02 →
- malignant mast cell neoplasm (C96.2-) inherited from D89.4Compare D89.41 vs C96.2 →
- malignant mastocytoma (C96.29) inherited from D89.4Compare D89.41 vs C96.29 →
- mast cell leukemia (C94.3-) inherited from D89.4Compare D89.41 vs C94.3 →
- mast cell sarcoma (C96.22) inherited from D89.4Compare D89.41 vs C96.22 →
- mastocytoma NOS (D47.09) inherited from D89.4Compare D89.41 vs D47.09 →
- other mast cell neoplasms of uncertain behavior (D47.09) inherited from D89.4Compare D89.41 vs D47.09 →
- systemic mastocytosis associated with a clonal hematologic non-mast cell lineage disease (SM-AHNMD) (D47.02) inherited from D89.4Compare D89.41 vs D47.02 →
- hyperglobulinemia NOS (R77.1) inherited from D89Compare D89.41 vs R77.1 →
- monoclonal gammopathy (of undetermined significance) (D47.2) inherited from D89Compare D89.41 vs D47.2 →
- autoimmune disease (systemic) NOS (M35.9) inherited from D80-D89Compare D89.41 vs M35.9 →
- functional disorders of polymorphonuclear neutrophils (D71-) inherited from D80-D89Compare D89.41 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.-) inherited from D89Compare D89.41 vs T86 →
- human immunodeficiency virus [HIV] disease (B20) inherited from D80-D89Compare D89.41 vs B20 →
Indexed Clinical Terms (1)
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.
- Activation, mast cell (disorder) (syndrome), monoclonal
Frequently Compared Codes
The official Excludes notes on D89.41 name these codes. Each comparison page covers when the two can — or must not — be reported together.
Change history
- Upcoming · effective FY2027 — 2026-10-01Excludes2 note will be addedhuman immunodeficiency virus [HIV] disease (B20)FY2027 changes
- Upcoming · effective FY2027 — 2026-10-01Excludes1 note will be removedhuman immunodeficiency virus [HIV] disease (B20)FY2027 changes
- FY2017 — 2016-10-01Added to the code setMonoclonal mast cell activation syndromeFY2017 changes
Verify Before Coding
- No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MS-DRG Grouper Relationships (FY2026)
Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.
Named in the grouper logic of 3 MS-DRGs: DRG 814 (MDC 16), DRG 815 (MDC 16), DRG 816 (MDC 16).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):BLD008 — Immunity disorders (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Immunity disorders).
D86.85 — Sarcoid myocarditis, D86.86 — Sarcoid arthropathy, D86.87 — Sarcoid myositis, D86.89 — Sarcoidosis of other sites, D86.9 — Sarcoidosis, unspecified, D89.0 — Polyclonal hypergammaglobulinemia, D89.1 — Cryoglobulinemia, D89.2 — Hypergammaglobulinemia, unspecified, D89.3 — Immune reconstitution syndrome, D89.40 — Mast cell activation, unspecified, D89.42 — Idiopathic mast cell activation syndrome, D89.43 — Secondary mast cell activation, D89.44 — Hereditary alpha tryptasemia, D89.49 — Other mast cell activation disorder, D89.810 — Acute graft-versus-host disease, D89.811 — Chronic graft-versus-host disease, D89.812 — Acute on chronic graft-versus-host disease, D89.813 — Graft-versus-host disease, unspecified, D89.82 — Autoimmune lymphoproliferative syndrome [ALPS], D89.831 — Cytokine release syndrome, grade 1, +64 more
Contextual Map
Every relationship of D89.41 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]
Clinical classification (CCSR)
- BLD008 — Immunity disorders [CCSR]
MS-DRG Grouper
- DRG 814 — RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC [MS-DRG]: “RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC (MDC 16)”
- DRG 815 — RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC [MS-DRG]: “RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC (MDC 16)”
- DRG 816 — RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC [MS-DRG]: “RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC (MDC 16)”
MDC crossing · procedures (1614)
- MDC 16 — Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders [MDC crossing]: “Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
- 02HV02Z — Insertion of Monitoring Device into Superior Vena Cava, Open Approach [Same-MDC procedure]: “Insertion of Monitoring Device into Superior Vena Cava, Open Approach — grouped in MDC 16, the procedure side of this code's crossing.” · check together
- 02HV0DZ — Insertion of Intraluminal Device into Superior Vena Cava, Open Approach [Same-MDC procedure]: “Insertion of Intraluminal Device into Superior Vena Cava, Open Approach — grouped in MDC 16, the procedure side of this code's crossing.” · check together
- 02HV3DZ — Insertion of Intraluminal Device into Superior Vena Cava, Percutaneous Approach [Same-MDC procedure]: “Insertion of Intraluminal Device into Superior Vena Cava, Percutaneous Approach — grouped in MDC 16, the procedure side of this code's crossing.” · check together
- 02HV42Z — Insertion of Monitoring Device into Superior Vena Cava, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Insertion of Monitoring Device into Superior Vena Cava, Percutaneous Endoscopic Approach — grouped in MDC 16, the procedure side of this code's crossing.” · check together
- 02HV4DZ — Insertion of Intraluminal Device into Superior Vena Cava, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Insertion of Intraluminal Device into Superior Vena Cava, Percutaneous Endoscopic Approach — grouped in MDC 16, the procedure side of this code's crossing.” · check together
- and 1609 more
Index entries
- Activation, mast cell (disorder) (syndrome), monoclonal[Index term]
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]
- D89.4 — Mast cell activation syndrome and related disorders [Sibling]
- D89.40 — Mast cell activation, unspecified [Sibling]
- D89.42 — Idiopathic mast cell activation syndrome [Sibling]
- and 20 more
Change history (3)
- FY2027 — Excludes2 note will be added [Change history]
- and 2 more
Nearest Codes in This Family
Official ICD-10-CM classifications closest to D89.41 in its code family, with their registry titles.
- D89.1 — Cryoglobulinemia
- D89.2 — Hypergammaglobulinemia, unspecified
- D89.3 — Immune reconstitution syndrome
- D89.4 — Mast cell activation syndrome and related disorders
- D89.40 — Mast cell activation, unspecified
- D89.42 — Idiopathic mast cell activation syndrome
- D89.43 — Secondary mast cell activation
- D89.44 — Hereditary alpha tryptasemia
- D89.49 — Other mast cell activation disorder
- D89.8 — Other specified disorders involving the immune mechanism, not elsewhere classified