E71.120 ICD-10-CM Code: Methylmalonic acidemia
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 5 Excludes1 · 1 Excludes2
- Risk adjustment
- CMS-HCC V22 category 23 · RxHCC V08 category 43
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 642 — INBORN AND OTHER DISORDERS OF METABOLISM (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.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for E71.120 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 E71.120 itself; “inherited from” names the category or block whose note applies here.
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).
- androgen insensitivity syndrome (E34.5-) Compare E71.120 vs E34.5 →
- congenital adrenal hyperplasia (E25.0) Compare E71.120 vs E25.0 →
- hemolytic anemias attributable to enzyme disorders (D55.-) Compare E71.120 vs D55 →
- Marfan syndrome (Q87.4-) Compare E71.120 vs Q87.4 →
- 5-alpha-reductase deficiency (E29.1) Compare E71.120 vs E29.1 →
Source: inherited from E70-E88
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- Ehlers-Danlos syndromes (Q79.6-) Compare E71.120 vs Q79.6 →
Source: inherited from E70-E88
Coder workflow for E71.120
MedCoder structured workflow — derived from this code’s own official record
Before you code E71.120
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with E71.120. 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 E71.120’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 E71.120. Then 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 E71.120(5 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with E71.120: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
CompareE34.5, E25.0, D55, Q87.4, E29.1
See the official tabular notes · Guidelines I.A.12.a
Excludes2 — not part of E71.120(1 note)
Coding workflow: The conditions named in this note are not included in E71.120. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareQ79.6
See the official tabular notes · Guidelines I.A.12.b
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: Both the condition E71.120 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 E71.120 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 8 Excludes1 notes across 3 chapters: E72 — Other disorders of amino-acid metabolism, P59 — Neonatal jaundice from other and unspecified causes (via E71.-), R79 — Other abnormal findings of blood chemistry (via E71.-), R79.83 — Abnormal findings of blood amino-acid level (via E71.-), R80 — Proteinuria (via E71.-), R80-R82 — Abnormal findings on examination of urine, without diagnosis (R80-R82) (via E71.-), R81 — Glycosuria (via E71.-), R82 — Other and unspecified abnormal findings in urine (via E71.-).
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
Referenced by 4 Excludes2 notes across 2 chapters: G11 — Hereditary ataxia (via E71.-), G71 — Primary disorders of muscles (via E71.-), N25.0 — Renal osteodystrophy (via E71.-), N25.81 — Secondary hyperparathyroidism of renal origin (via E71.-).
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
Referenced by 2 Code First instructions across 2 chapters: G63 — Polyneuropathy in diseases classified elsewhere (via E71.-), H42 — Glaucoma in diseases classified elsewhere (via E71.-).
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.
Referenced by 1 Code Also instruction: D59.32 — Hereditary hemolytic-uremic syndrome.
These codes suggest coding this condition alongside when both are present.
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 140 clinically related codes on its CMS exclusion list.
Named in the grouper logic of 1 MS-DRG: DRG 642 (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):END016 — Other specified and unspecified nutritional and metabolic 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.
E70.41 — Histidinemia, E70.49 — Other disorders of histidine metabolism, E70.5 — Disorders of tryptophan metabolism, E70.81 — Aromatic L-amino acid decarboxylase deficiency, E70.89 — Other disorders of aromatic amino-acid metabolism, E70.9 — Disorder of aromatic amino-acid metabolism, unspecified, E71.0 — Maple-syrup-urine disease, E71.110 — Isovaleric acidemia, E71.111 — 3-methylglutaconic aciduria, E71.118 — Other branched-chain organic acidurias, E71.121 — Propionic acidemia, E71.128 — Other disorders of propionate metabolism, E71.19 — Other disorders of branched-chain amino-acid metabolism, E71.2 — Disorder of branched-chain amino-acid metabolism, unspecified, E71.30 — Disorder of fatty-acid metabolism, unspecified, E72.00 — Disorders of amino-acid transport, unspecified, E72.01 — Cystinuria, E72.02 — Hartnup's disease, E72.04 — Cystinosis, E72.09 — Other disorders of amino-acid transport, +119 more
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified and unspecified nutritional and metabolic disorders).
E70.49 — Other disorders of histidine metabolism, E70.5 — Disorders of tryptophan metabolism, E70.8 — Other disorders of aromatic amino-acid metabolism, E70.81 — Aromatic L-amino acid decarboxylase deficiency, E70.89 — Other disorders of aromatic amino-acid metabolism, E70.9 — Disorder of aromatic amino-acid metabolism, unspecified, E71.0 — Maple-syrup-urine disease, E71.110 — Isovaleric acidemia, E71.111 — 3-methylglutaconic aciduria, E71.118 — Other branched-chain organic acidurias, E71.121 — Propionic acidemia, E71.128 — Other disorders of propionate metabolism, E71.19 — Other disorders of branched-chain amino-acid metabolism, E71.2 — Disorder of branched-chain amino-acid metabolism, unspecified, E71.30 — Disorder of fatty-acid metabolism, unspecified, E71.310 — Long chain/very long chain acyl CoA dehydrogenase deficiency, E71.311 — Medium chain acyl CoA dehydrogenase deficiency, E71.312 — Short chain acyl CoA dehydrogenase deficiency, E71.313 — Glutaric aciduria type II, E71.314 — Muscle carnitine palmitoyltransferase deficiency, +258 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Acidemia”; these codes share that main term but sit in a different category of the Tabular List.
E72.22 — Arginosuccinic aciduria (argininosuccinic), E72.3 — Disorders of lysine and hydroxylysine metabolism (pipecolic), E87.20 — Acidosis, unspecified, P19.0 — Metabolic acidemia in newborn first noted before onset of labor (metabolic, newborn, first noted before onset of labor), P19.1 — Metabolic acidemia in newborn first noted during labor (metabolic, newborn, first noted during labor), P19.2 — Metabolic acidemia noted at birth (metabolic, newborn, noted at birth), P19.9 — Metabolic acidemia in newborn, unspecified (metabolic, newborn)
Contextual Map
Every relationship of E71.120 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 E71.120 with these 15 related codes 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
- E70-E88 — Metabolic disorders[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Excludes1 notes
- E72 — Other disorders of amino-acid metabolism[Excludes1]: “branched-chain amino-acid metabolism (E71.0-E71.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- P59 — Neonatal jaundice from other and unspecified causes[Excludes1](via E71.-): “jaundice due to inborn errors of metabolism (E70-E88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R79 — Other abnormal findings of blood chemistry[Excludes1](via E71.-): “specific findings indicating disorder of amino-acid metabolism (E70-E72)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R79.83 — Abnormal findings of blood amino-acid level[Excludes1](via E71.-): “disorders of amino-acid metabolism (E70-E72)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R80 — Proteinuria[Excludes1](via E71.-): “specific findings indicating disorder of amino-acid metabolism (E70-E72)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R80-R82 — Abnormal findings on examination of urine, without diagnosis (R80-R82)[Excludes1](via E71.-): “specific findings indicating disorder of amino-acid metabolism (E70-E72)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R81 — Glycosuria[Excludes1](via E71.-): “specific findings indicating disorder of amino-acid metabolism (E70-E72)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R82 — Other and unspecified abnormal findings in urine[Excludes1](via E71.-): “specific findings indicating disorder of amino-acid metabolism (E70-E72)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes2 notes
- G11 — Hereditary ataxia[Excludes2](via E71.-): “metabolic disorders (E70-E88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- G71 — Primary disorders of muscles[Excludes2](via E71.-): “metabolic disorders (E70-E88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- N25.0 — Renal osteodystrophy[Excludes2](via E71.-): “metabolic disorders classifiable to E70-E88”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- N25.81 — Secondary hyperparathyroidism of renal origin[Excludes2](via E71.-): “metabolic disorders classifiable to E70-E88”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Code First instructions
- G63 — Polyneuropathy in diseases classified elsewhere[Code First](via E71.-): “metabolic diseases (E70-E88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- H42 — Glaucoma in diseases classified elsewhere[Code First](via E71.-): “specified metabolic disorder (E70-E88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Code Also instructions
- D59.32 — Hereditary hemolytic-uremic syndrome[Code Also]: “methylmalonic acidemia (E71.120)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Clinical classification (CCSR)
- END016 — Other specified and unspecified nutritional and metabolic disorders[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
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 642 — INBORN AND OTHER DISORDERS OF METABOLISM[MS-DRG]: “INBORN AND OTHER DISORDERS OF METABOLISM (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
- Acidemia, methylmalonic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Disorder (of), metabolism NOS, amino-acid, branched chain, methylmalonic acidemia[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Disorder (of), methylmalonic acidemia[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Methylmalonic acidemia[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Nearest codes (40)
- E71 — Disorders of branched-chain amino-acid metabolism and fatty-acid metabolism[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E71.0 — Maple-syrup-urine disease[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E71.1 — Other disorders of branched-chain amino-acid metabolism[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E71.11 — Branched-chain organic acidurias[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E71.110 — Isovaleric acidemia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E71.111 — 3-methylglutaconic aciduria[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E71.118 — Other branched-chain organic acidurias[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E71.12 — Disorders of propionate metabolism[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
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
- 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
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionMethylmalonic acidemia
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to E71.120 in its code family, with their registry titles.
- E71.11 — Branched-chain organic acidurias
- E71.110 — Isovaleric acidemia
- E71.111 — 3-methylglutaconic aciduria
- E71.118 — Other branched-chain organic acidurias
- E71.12 — Disorders of propionate metabolism
- E71.121 — Propionic acidemia
- E71.128 — Other disorders of propionate metabolism
- E71.19 — Other disorders of branched-chain amino-acid metabolism
- E71.2 — Disorder of branched-chain amino-acid metabolism, unspecified
- E71.3 — Disorders of fatty-acid metabolism