E74.4Disorders of pyruvate metabolism and gluconeogenesis

E74.4 is the ICD-10-CM diagnosis code for disorders of pyruvate metabolism and gluconeogenesis. It belongs to category E74 (other disorders of carbohydrate metabolism), block E70-E88 (metabolic disorders) and chapter 4 (endocrine, nutritional and metabolic diseases). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within E74 (other disorders of carbohydrate metabolism), E74.4 is specifically for disorders of pyruvate metabolism and gluconeogenesis. Related codes cover glycogen storage disease (E74.0), disorders of fructose metabolism (E74.1), disorders of galactose metabolism (E74.2), other disorders of intestinal carbohydrate absorption (E74.3), other specified disorders of carbohydrate metabolism (E74.8) and disorder of carbohydrate metabolism, unspecified (E74.9).

Don't report E74.4 together with the conditions in its Excludes1 note: disorders of pyruvate metabolism and gluconeogenesis with anemia (D55.-) and Leigh's syndrome (G31.82).

As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 642 (Inborn and Other Disorders of Metabolism, relative weight 1.3219), in MDC 10 (Endocrine, Nutritional and Metabolic Diseases and Disorders), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as 271.0 (glycogenosis) and 271.8 (other specified disorders of carbohydrate transport and metabolism).