ICD-10 Code E67.1: Hypercarotenemia diagnosis and coding guide

Key Takeaways

ICD-10 Code E67.1 is the billable diagnosis code for hypercarotenemia, valid for FY2026 (October 1, 2025 through September 30, 2026)

Hypercarotenemia means elevated carotene in the blood. It causes yellow-orange skin discoloration (carotenodermia) without scleral icterus, distinguishing it from jaundice

E67.1 must not be confused with hypervitaminosis A (E67.0) or jaundice (R17). Each has distinct clinical criteria and separate Excludes1 notes

Pabau’s claims management software includes an ICD-10 code search to enter E67.1 accurately and link it directly to encounter notes and superbills

ICD-10 Code E67.1 is the billable diagnosis code for hypercarotenemia, an elevated level of carotene in the blood that turns the skin a yellow-orange shade.

The detail that separates it from jaundice is the sclera. In hypercarotenemia the whites of the eyes stay clear, so a patient eating plenty of carrots, sweet potatoes, or carotenoid supplements codes to E67.1, not R17.

This guide covers what coders and clinicians need to assign E67.1 cleanly: billable status, the ICD-10-CM hierarchy, documentation requirements, Excludes1 rules, and how to tell it apart from the codes it is most often confused with.

ICD-10 Code E67.1: Billable status and validity period

E67.1 is a billable ICD-10-CM diagnosis code. It is valid for HIPAA-covered transactions for the fiscal year 2026 coding cycle, which runs from October 1, 2025 through September 30, 2026.

Clinicians and coders can use it as a standalone principal or secondary diagnosis code without requiring a more specific sub-code. The CMS ICD-10 coding page lists E67.1 as an active code in the current tabular list.

Because it satisfies HIPAA-covered transaction requirements at the full five-character level, no additional digit is needed for claim submission. That makes it straightforward to enter once the clinical documentation supports the diagnosis.

E67.1 code details at a glance

The table below summarizes the key administrative and billing attributes of E67.1 as defined in the ICD-10-CM tabular list.

ICD-10-CM classification: Where E67.1 fits

Understanding the hierarchy helps with sequencing decisions and cross-referencing related codes. The same E65-E68 block that holds E67.1 also contains E65, a sibling code for localized adiposity, which shows how chapters and blocks are structured across the endocrine and metabolic chapter.

• Chapter: E00-E89 (Endocrine, nutritional and metabolic diseases)
• Block: E65-E68 (Overweight, obesity and other hyperalimentation)
• Category: E67 (Other hyperalimentation)
• Code: E67.1 (Hypercarotenemia)

The sibling codes under E67 are E67.0 (Hypervitaminosis A), E67.2 (Megavitamin-B6 syndrome), E67.3 (Hypervitaminosis D), and E67.8 (Other specified hyperalimentation). Coders should confirm which sibling code applies before defaulting to E67.1. Only elevated carotene, not elevated retinol (vitamin A), maps to E67.1.

Clinical description of hypercarotenemia

Hypercarotenemia is defined as an elevated concentration of carotenoids in the blood, most commonly beta-carotene. The condition is generally benign and self-limiting. Its primary clinical presentation is carotenodermia, a yellow-orange discoloration of the skin, particularly noticeable on the palms, soles, and nasolabial folds.

Clinicians using dermatology EMR software that supports structured skin documentation will find this distinction relevant to accurate record-keeping.

Causes and risk factors

The most common cause is high dietary intake of carotenoid-rich foods. Practitioners in functional medicine software-supported practices, where nutritional supplementation and elimination diets are common, are more likely to encounter this diagnosis. Key causes include:

• High consumption of carrots, sweet potatoes, pumpkin, or dark leafy greens
• Carotenoid supplementation (beta-carotene capsules)
• Hypothyroidism (E03.9), which impairs carotenoid-to-vitamin-A conversion
• Diabetes mellitus (E11.9), a similar conversion impairment
• Anorexia nervosa (high vegetable intake with low caloric load)
• Liver disease affecting carotenoid metabolism

Signs and symptoms for clinical documentation

The yellow-orange skin tinge of carotenodermia is clinically distinct from jaundice. The key differentiator for documentation purposes is the absence of scleral icterus in hypercarotenemia. Jaundice affects the whites of the eyes. Carotenodermia does not.

Documenting this distinction in the clinical note directly supports assignment of E67.1 over R17 and satisfies medical necessity requirements. According to the CDC/NCHS ICD-10-CM tool, the yellowish discoloration without scleral involvement is a defining clinical marker for accurate code assignment.

Treatment and prognosis

Hypercarotenemia is benign and self-limiting, and that shapes both counseling and coding. There is no drug treatment. The yellow-orange tint fades on its own once carotenoid intake drops, usually over several weeks to a few months, clearing from the palms and soles last.

When a metabolic cause is driving it, the fix is the underlying condition rather than the carotene itself. Treating hypothyroidism or managing diabetes restores normal carotene-to-vitamin-A conversion, and the skin color follows. This benign course is the practical reason E67.1 sits apart from vitamin A toxicity (E67.0), where excess retinol can actually be harmful.

Approximate synonyms and alternate index terms

Multiple terms map to E67.1 in the ICD-10-CM alphabetic index. Knowing them helps when searching EHRs or superbill templates. The following terms are all accepted synonyms for E67.1:

• Carotenemia
• Carotenosis
• Xanthemia
• Hypercarotenaemia (British spelling variant)
• Carotenodermia (when used as a diagnosis, not just a symptom descriptor)

When a clinician documents “carotenemia” or “carotenosis” in the encounter note, the coder maps this directly to E67.1. No additional specificity is required because the code is already at its most specific level.

E67.1 coding guidelines and documentation requirements

Assigning E67.1 correctly requires specific clinical documentation. Every ICD-10-CM code, including codes like F05, needs a clinical note that directly supports the diagnosis chosen. For E67.1 specifically, the note must contain:

• A confirmed clinical finding of elevated carotene or carotenodermia
• Absence of scleral icterus (to distinguish from jaundice)
• Relevant dietary or metabolic history supporting the etiology
• Lab confirmation of elevated serum carotenoids where available

Excludes1 and coding exclusions

E67.1 does not carry a dedicated Excludes1 note at the individual code level. However, the parent category E67 (Other hyperalimentation) has relevant exclusion guidance that applies to all sub-codes.

Coders must not assign E67.1 when the condition is the result of vitamin A excess rather than carotene excess. Vitamin A toxicity codes to E67.0 (Hypervitaminosis A), not E67.1.

The use of digital intake forms that capture supplement histories helps clinicians distinguish between the two at the point of care before the coding decision is made.

At the category level, the E67 block also excludes hyperalimentation not otherwise specified (R63.2) and sequelae of hyperalimentation (E68). Neither maps to E67.1, so confirm the documentation describes carotene excess specifically before assigning the code.

Important: Hypercarotenemia does not cause vitamin A toxicity. Dietary carotene converts to vitamin A only as needed. Excess is stored in the skin, not accumulated as retinol. Conflating the two conditions is a common documentation error that leads to miscoding.

Differentiating E67.1 from vitamin A toxicity and jaundice

Three separate conditions cause yellowing or skin discoloration and frequently get miscoded. The table below draws the clinical and coding distinctions that matter at the point of documentation. The AAPC ICD-10-CM code lookup confirms the separate code assignments for each.

Related ICD-10-CM codes

The codes below are hierarchically or clinically related to E67.1. Sibling and parent codes interact this way across other categories too, including M24.9. The WHO ICD-10 browser provides the international classification context for the E67 category.

How to use E67.1 in EHR and practice management software

Entering E67.1 accurately in an EHR or practice management system requires three steps: code search, encounter linkage, and superbill assignment. Practices using claims management software that integrates ICD-10 code search can reduce entry errors significantly.

For practices managing patient records electronically, the diagnosis should be added to the active problem list when the condition is ongoing, for example in a patient with untreated hypothyroidism driving persistent carotenemia.

• Principal diagnosis use: Assign E67.1 as the principal code when the hypercarotenemia is the primary reason for the encounter (for example, a nutritional consultation prompted by carotenodermia)
• Secondary diagnosis use: Assign E67.1 as secondary when the encounter is for a related condition (for example, hypothyroidism with incidental carotenemia)
• Superbill placement: Add E67.1 to the superbill after confirming it is supported by the encounter note. Unsupported code entries risk audit queries
• Lab linkage: If a serum carotenoid panel was ordered, link the ordering CPT code to E67.1 as the supporting diagnosis for medical necessity

Pabau’s claims management workflow supports ICD-10 code attachment at the encounter level, reducing the risk of submitting a claim without a linked diagnosis. Practices interested in streamlining their billing workflows can book a demo to see how E67.1 and similar nutritional diagnosis codes integrate into automated claim generation.

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Practices dealing with EHR integration for practice management should also verify that their system’s ICD-10 database is updated to the FY2026 edition. An outdated code table may reject E67.1 even though it is an active, billable code.

Conclusion

Yellow skin without scleral icterus in a patient eating a high-carotenoid diet points directly to E67.1, not R17. The coding distinction is straightforward once the clinical documentation is in place: confirm carotenodermia, confirm absent scleral icterus, and confirm the dietary or metabolic history.

Pabau’s claims management software supports ICD-10 diagnosis code attachment at the encounter level, so E67.1 links cleanly to the encounter note before claim submission.

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