E34.01 ICD-10-CM Code: Carcinoid heart syndrome
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 2 inclusion terms · 3 Excludes1 · 3 code-also instructions
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.
- MS-DRG 643 — ENDOCRINE DISORDERS WITH MCC (MDC 10)
- MS-DRG 644 — ENDOCRINE DISORDERS WITH CC (MDC 10)
- MS-DRG 645 — ENDOCRINE DISORDERS WITHOUT CC/MCC (MDC 10)
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.
Risk Adjustment (CMS-HCC)
Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.
- HCC 17 — Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic (supersedes HCC 18, HCC 19, HCC 20, HCC 21, HCC 22, HCC 23)
Other models: CMS-HCC V22 HCC 12 · RxHCC V08 HCC 22
Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for E34.01 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on E34.01 itself; “inherited from” names the category or block whose note applies here.
Inclusion Terms
Alternative terms the tabular list files under this code.
- Carcinoid heart disease
- Hedinger syndrome
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).
- pseudohypoparathyroidism (E20.1) inherited from E34Compare E34.01 vs E20.1 →
- galactorrhea (N64.3) inherited from E20-E35Compare E34.01 vs N64.3 →
- gynecomastia (N62) inherited from E20-E35Compare E34.01 vs N62 →
Coder workflow for E34.01
MedCoder structured workflow — derived from this code’s own official record
Before you code E34.01
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with E34.01. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
Choose the right path
- Does the documentation support a condition named in E34.01’s Excludes1 note?
Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
No → Continue.
Consider E34.01. Then review the Code Also note, and confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Official instructions as workflow
Excludes1 — check before selecting E34.01(3 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with E34.01: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
See the official tabular notes · Guidelines I.A.12.a
Code Also — related condition(3 notes)
Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.
See the official tabular notes · Guidelines I.A.17
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: Both the condition E34.01 describes and a condition named in its Excludes1 note are documented for the same encounter.
Coding question: Can both codes be reported?
Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.
Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Indexed Clinical Terms (4)
Official source data — entries quoted as published, in the Index’s own lookup phrasing
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.
Verify Before Coding
- CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.
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
MedCoder structured relationships — computed from published CMS and AHRQ datasets
Other codes that name E34.01 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 1 Code First instruction: G63 — Polyneuropathy in diseases classified elsewhere (via E34.-).
Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.
MS-DRG Grouper Relationships (FY2026)
Potential MS-DRG participation — not a DRG assignment.
FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 11 clinically related codes on its CMS exclusion list.
Named in the grouper logic of 3 MS-DRGs: DRG 643 (MDC 10), DRG 644 (MDC 10), DRG 645 (MDC 10).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):END015 — Other specified and unspecified endocrine 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 process (MS-DRG)
Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.
E30.9 — Disorder of puberty, unspecified, E34.00 — Carcinoid syndrome, unspecified, E34.09 — Other carcinoid syndrome, E34.1 — Other hypersecretion of intestinal hormones, E34.2 — Ectopic hormone secretion, not elsewhere classified, E34.50 — Androgen insensitivity syndrome, unspecified, E34.51 — Complete androgen insensitivity syndrome, E34.52 — Partial androgen insensitivity syndrome, E34.8 — Other specified endocrine disorders, E34.9 — Endocrine disorder, unspecified
Same CMS-HCC risk category (V28)
CMS maps these diagnoses to the same Hierarchical Condition Category (Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic) for risk-adjusted payment.
C92.A1 — Acute myeloid leukemia with multilineage dysplasia, in remission, C92.A2 — Acute myeloid leukemia with multilineage dysplasia, in relapse, C93.00 — Acute monoblastic/monocytic leukemia, not having achieved remission, C93.01 — Acute monoblastic/monocytic leukemia, in remission, C93.02 — Acute monoblastic/monocytic leukemia, in relapse, C94.00 — Acute erythroid leukemia, not having achieved remission, C94.01 — Acute erythroid leukemia, in remission, C94.02 — Acute erythroid leukemia, in relapse, C94.20 — Acute megakaryoblastic leukemia not having achieved remission, C94.21 — Acute megakaryoblastic leukemia, in remission, C94.22 — Acute megakaryoblastic leukemia, in relapse, C94.40 — Acute panmyelosis with myelofibrosis not having achieved remission, C94.41 — Acute panmyelosis with myelofibrosis, in remission, C94.42 — Acute panmyelosis with myelofibrosis, in relapse, D46.22 — Refractory anemia with excess of blasts 2, E34.00 — Carcinoid syndrome, unspecified, E34.09 — Other carcinoid syndrome, I31.31 — Malignant pericardial effusion in diseases classified elsewhere, J91.0 — Malignant pleural effusion, R18.0 — Malignant ascites, +57 more
Related risk categories
These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.
Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid, Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers, Lung and Other Severe Cancers, Lymphoma and Other Cancers, Bladder, Colorectal, and Other Cancers, Prostate, Breast, and Other Cancers and Tumors
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified and unspecified endocrine disorders).
E31.22 — Multiple endocrine neoplasia [MEN] type IIA, E31.23 — Multiple endocrine neoplasia [MEN] type IIB, E31.8 — Other polyglandular dysfunction, E31.9 — Polyglandular dysfunction, unspecified, E32.0 — Persistent hyperplasia of thymus, E32.1 — Abscess of thymus, E32.8 — Other diseases of thymus, E32.9 — Disease of thymus, unspecified, E34.0 — Carcinoid syndrome, E34.00 — Carcinoid syndrome, unspecified, E34.09 — Other carcinoid syndrome, E34.1 — Other hypersecretion of intestinal hormones, E34.2 — Ectopic hormone secretion, not elsewhere classified, E34.3 — Short stature due to endocrine disorder, E34.30 — Short stature due to endocrine disorder, unspecified, E34.31 — Constitutional short stature, E34.321 — Primary insulin-like growth factor-1 (IGF-1) deficiency, E34.322 — Insulin-like growth factor-1 (IGF-1) resistance, E34.328 — Other genetic causes of short stature, E34.329 — Unspecified genetic causes of short stature, +83 more
Contextual Map
Every relationship of E34.01 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.
Run E34.01 with this related code in Claim Check
Hierarchy
- E00-E89 — Chapter 4: Endocrine, Nutritional and Metabolic Diseases (E00-E89) (E00-E89)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E20-E35 — Disorders of other endocrine glands[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Code First instructions
- G63 — Polyneuropathy in diseases classified elsewhere[Code First](via E34.-): “endocrine disease, except diabetes (E00-E07, E15-E16, E20-E34)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Clinical classification (CCSR)
- END015 — Other specified and unspecified endocrine disorders[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
Risk adjustment (CMS-HCC)
- HCC 17 — Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic [CMS-HCC]: “Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic — supersedes HCC 18 (Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid), HCC 19 (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers), HCC 20 (Lung and Other Severe Cancers), HCC 21 (Lymphoma and Other Cancers), HCC 22 (Bladder, Colorectal, and Other Cancers), HCC 23 (Prostate, Breast, and Other Cancers and Tumors)”— CMS-HCC V28 · 2026
MS-DRG Grouper
- CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
- DRG 643 — ENDOCRINE DISORDERS WITH MCC[MS-DRG]: “ENDOCRINE DISORDERS WITH MCC (MDC 10)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 644 — ENDOCRINE DISORDERS WITH CC[MS-DRG]: “ENDOCRINE DISORDERS WITH CC (MDC 10)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 645 — ENDOCRINE DISORDERS WITHOUT CC/MCC[MS-DRG]: “ENDOCRINE DISORDERS WITHOUT CC/MCC (MDC 10)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
MDC crossing
- MDC 10 — Endocrine, Nutritional and Metabolic Diseases and Disorders[MDC crossing]: “Endocrine, Nutritional and Metabolic Diseases and 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. 5,008 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
Index entries
- Carcinoidosis, heart[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Disease, diseased, carcinoid, heart[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Syndrome, carcinoid, heart[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Syndrome, Hedinger's[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Nearest codes (22)
- E34 — Other endocrine disorders[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E34.0 — Carcinoid syndrome[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E34.00 — Carcinoid syndrome, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E34.09 — Other carcinoid syndrome[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E34.1 — Other hypersecretion of intestinal hormones[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E34.2 — Ectopic hormone secretion, not elsewhere classified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E34.3 — Short stature due to endocrine disorder[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E34.30 — Short stature due to endocrine disorder, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 14 more
Change history
- FY2025 — Added to the code set[Change history]— CMS release files (code change ledger) · icd10cm-fy2025
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
- Risk adjustment Official source data
- 2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "E34.01 — Carcinoid heart syndrome." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/e34.01-carcinoid-heart-syndrome
Change history
- FY2025 — October 1, 2024Added to the code setCarcinoid heart syndromeFY2025 changes
Nearest Codes in This Family
Official ICD-10-CM classifications closest to E34.01 in its code family, with their registry titles.
- E34 — Other endocrine disorders
- E34.0 — Carcinoid syndrome
- E34.00 — Carcinoid syndrome, unspecified
- E34.09 — Other carcinoid syndrome
- E34.1 — Other hypersecretion of intestinal hormones
- E34.2 — Ectopic hormone secretion, not elsewhere classified
- E34.3 — Short stature due to endocrine disorder
- E34.30 — Short stature due to endocrine disorder, unspecified
- E34.31 — Constitutional short stature
- E34.32 — Genetic causes of short stature