E87.4 Mixed disorder of acid-base balance

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Applies from E87 Other disorders of fluid, electrolyte and acid-base balance

Excludes1 (never code together)

• diabetes insipidus (E23.2)
• electrolyte imbalance associated with hyperemesis gravidarum (O21.1)
• electrolyte imbalance following ectopic or molar pregnancy (O08.5)
• familial periodic paralysis (G72.3)
• metabolic acidemia in newborn, unspecified (P19.9)

MS-DRG index

Defines the logic of DRG(s) 640-641 in MDC 10.

Approximate ICD-9-CM (GEMs)

• 276.4 Mixed acid-base balance disorder

Code annotations containing back-references to E87.4

Back-references to E87

• Use Additional: E86 Volume depletion ("code(s) for any associated disorders of electrolyte and acid-base balance (E87.-)")
• Type 2 Excludes: G11 Hereditary ataxia ("metabolic disorders (E70-E88)")
• Code First: G63 Polyneuropathy in diseases classified elsewhere ("metabolic diseases (E70-E88)")
• Type 2 Excludes: G71 Primary disorders of muscles ("metabolic disorders (E70-E88)")
• Code First: H42 Glaucoma in diseases classified elsewhere ("specified metabolic disorder (E70-E88)")
• Type 2 Excludes: N25.0 Renal osteodystrophy ("metabolic disorders classifiable to E70-E88")
• Type 2 Excludes: N25.81 Secondary hyperparathyroidism of renal origin ("metabolic disorders classifiable to E70-E88")
• Type 1 Excludes: P59 Neonatal jaundice from other and unspecified causes ("jaundice due to inborn errors of metabolism (E70-E88)")
• Type 2 Excludes: R79.1 Abnormal coagulation profile ("abnormality of fluid, electrolyte or acid-base balance (E86-E87)")

Diagnosis Index entries for E87.4

• Abnormal, abnormality, abnormalities › acid-base balance (mixed)
• Acidosis (lactic) › metabolic NEC › with respiratory acidosis
• Acidosis (lactic) › respiratory › complicated by › metabolic › acidosis
• Acidosis (lactic) › respiratory › complicated by › metabolic › alkalosis
• Alkalosis › metabolic › with respiratory acidosis
• Disorder (of) › balance › acid-base › mixed
• Disturbance (s) › acid-base equilibrium › mixed

Nearby codes

• E87.20 Acidosis, unspecified
• E87.21 Acute metabolic acidosis
• E87.22 Chronic metabolic acidosis
• E87.29 Other acidosis
• E87.3 Alkalosis
• E87.4 Mixed disorder of acid-base balance (this code)
• E87.5 Hyperkalemia
• E87.6 Hypokalemia
• E87.7 Fluid overload
• E87.70 Fluid overload, unspecified
• E87.71 Transfusion associated circulatory overload