E87.4Mixed disorder of acid-base balance

E87.4 is the ICD-10-CM diagnosis code for mixed disorder of acid-base balance. It belongs to category E87 (other disorders of fluid, electrolyte and acid-base balance), 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 E87 (other disorders of fluid, electrolyte and acid-base balance), E87.4 is specifically for mixed disorder of acid-base balance. Related codes cover Hyperosmolality and hypernatremia (E87.0), Hypo-osmolality and hyponatremia (E87.1), acidosis (E87.2), Alkalosis (E87.3), Hyperkalemia (E87.5), Hypokalemia (E87.6), fluid overload (E87.7) and other disorders of electrolyte and fluid balance, not elsewhere classified (E87.8).

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 640 (Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes with MCC, relative weight 1.3395), DRG 641 (Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes without MCC, relative weight 0.7865), DRG 791 (Prematurity with Major Problems, relative weight 4.1075) and DRG 793 (Full Term Neonate with Major Problems, relative weight 4.2195), in MDC 10 (Endocrine, Nutritional and Metabolic Diseases and Disorders) and MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period), 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 276.4 (mixed acid-base balance disorder).