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Diabetes ICD-10 Codes: Complete Coding Guide (E08-E13)

  • Jan 20, 2025

Diabetes mellitus is one of the most frequently coded conditions in healthcare. With over 320 diagnosis codes spanning categories E08 through E13, accurate diabetes coding requires understanding the type of diabetes, associated complications, and proper sequencing rules. ICD-10-CM organizes diabetes codes into six main categories: E08 for secondary diabetes (underlying disease), E09 for drug or chemical-induced, E10 for Type 1 (insulin-dependent), E11 for Type 2 (most common form, ~90-95% of cases), E12 for malnutrition-related (rare/merged into E13), and E13 for other specified types (postpancreatectomy, postprocedural). Total diabetes codes: 323; billable codes: 237.

Code Families

E11: Type 2 Diabetes Mellitus (Most Common) — Type 2 accounts for approximately 90-95% of diabetes cases. The E11 category includes 48 billable codes organized by complication type: .0 (Hyperosmolarity), .1 (Ketoacidosis), .2 (Kidney complications), .3 (Ophthalmic complications), .4 (Neurological complications), .5 (Circulatory complications), .6 (Other specified complications), .8 (Unspecified complications), .9 (Without complications), .A (In remission). Most frequently used codes: E11.9 (without complications), E11.65 (with hyperglycemia), E11.22 (diabetic chronic kidney disease), E11.40 (diabetic neuropathy, unspecified), E11.42 (diabetic polyneuropathy), E11.319 (unspecified retinopathy without macular edema), E11.621 (foot ulcer). E11 includes diabetes due to insulin secretory defect, Diabetes NOS, and insulin resistant diabetes. Excludes1: E08 (secondary), E09 (drug-induced), O24.4 (gestational), P70.2 (neonatal), E13 (postpancreatectomy/postprocedural), E10 (Type 1). Use additional codes to identify insulin use (Z79.4), oral antidiabetic drugs (Z79.84), or injectable non-insulin agents (Z79.85).

E10: Type 1 Diabetes Mellitus — An autoimmune condition where the pancreas produces little or no insulin. E10 category has 48 billable codes with similar structure to E11, but lacks hyperosmolarity codes (E10.0 does not exist). Differences from Type 2: Ketoacidosis more common in E10; presymptomatic code E10.A vs remission E11.A; typical onset childhood/young adult; insulin always required. Common E10 codes: E10.9 (without complications), E10.10 (ketoacidosis without coma), E10.65 (with hyperglycemia), E10.22 (diabetic chronic kidney disease), E10.42 (diabetic polyneuropathy). Do NOT assign Z79.4 (insulin use) with E10 — insulin use is inherent to Type 1.

E08: Diabetes Due to Underlying Condition — Use E08 codes when diabetes is secondary to another disease; underlying condition must be coded first. Common causes: chronic pancreatitis, cystic fibrosis, hemochromatosis, Cushing syndrome, acromegaly. Coding rule: Code first the underlying condition, then assign the appropriate E08 code.

E09: Drug or Chemical Induced Diabetes — E09 codes used when diabetes caused by medications or toxic substances. Common causative agents: glucocorticoids/steroids, antipsychotic medications, beta-blockers, thiazide diuretics, chemotherapy agents. Coding rules: Code first poisoning due to drug or toxin if applicable (T36-T65); use additional code for adverse effect if applicable (T36-T50 with fifth or sixth character 5).

E13: Other Specified Diabetes Mellitus — E13 codes cover diabetes types not classified in E08-E11: postpancreatectomy diabetes mellitus, postprocedural diabetes mellitus, secondary diabetes mellitus NEC.

Diabetic Complications Coding — Ophthalmic (x.3x): Diabetic retinopathy codes specify retinopathy stage (mild, moderate, severe nonproliferative; proliferative), macular edema status (with/without), retinal detachment location. Examples: E11.311 (unspecified retinopathy with macular edema), E11.3211 (mild NPDR with macular edema, right eye), E11.3512 (proliferative retinopathy with macular edema, left eye). Use additional code for macular edema (H35.81-). Kidney (x.2x): x.21 (Diabetic nephropathy - earliest stage), x.22 (Diabetic chronic kidney disease - use additional N18.- for CKD stage), x.29 (Other diabetic kidney complication). Neurological (x.4x): x.40 (Neuropathy, unspecified), x.41 (Mononeuropathy), x.42 (Polyneuropathy - most common), x.43 (Autonomic polyneuropathy), x.44 (Amyotrophy), x.49 (Other neurological). Circulatory (x.5x): x.51 (Peripheral angiopathy without gangrene), x.52 (Peripheral angiopathy with gangrene), x.59 (Other circulatory). Skin (x.62x): x.620 (Dermatitis), x.621 (Foot ulcer - use additional L97.4-, L97.5-), x.622 (Other skin ulcer - use additional L97.1-L97.9, L98.41-L98.49), x.628 (Other skin complications).

Coding Scenarios

Type 2 Diabetes with CKD Stage 3 — T2DM with diabetic nephropathy, GFR 45, stage 3 CKD attributed to diabetes, A1c 7.8%. Codes: E11.22 (Type 2 with diabetic chronic kidney disease) + N18.3 (CKD stage 3 moderate). E11.22 captures diabetic etiology of CKD; per guidelines, always assign additional N18.- code to identify CKD stage.

Type 2 Diabetes with Foot Ulcer and Neuropathy — T2DM with diabetic polyneuropathy and chronic foot ulcer on left heel, fat layer exposed. Codes: E11.42 (diabetic polyneuropathy) + E11.621 (foot ulcer) + L97.422 (left heel ulcer, fat layer exposed). Assign as many E11 complication codes as needed; foot ulcer always requires additional L97.- code for site and severity.

Steroid-Induced Diabetes with Hyperglycemia — Diabetes onset after 6 months prednisone for RA, fasting glucose 280, started on metformin. Codes: E09.65 (drug or chemical induced with hyperglycemia) + T38.0X5A (adverse effect of glucocorticoids, initial). Use E09 for drug-induced diabetes (not E11); adverse effect code identifies causative drug. Use Z79.4 as additional code if patient requires insulin.

Type 1 Diabetes with DKA — T1DM with DKA: blood glucose 450, pH 7.18, ketones positive, alert and oriented, no loss of consciousness. Code: E10.10 (Type 1 with ketoacidosis without coma). "Without coma" (E10.10) vs "with coma" (E10.11) determined by altered consciousness status. Do NOT assign Z79.4 with E10 — insulin use is inherent to Type 1.

Secondary Diabetes with Retinopathy — Diabetes secondary to chronic pancreatitis, new diagnosis: mild NPDR without macular edema, bilateral. Codes: K86.1 (chronic pancreatitis, code first) + E08.329 (secondary diabetes with mild NPDR without macular edema) + H35.0291 (mild NPDR bilateral). E08 requires underlying condition sequenced first; retinopathy code must specify macular edema status and laterality.

Diabetes with Multiple Complications — Assign as many codes from diabetes category as necessary to describe all documented complications. Each complication captured with most specific code available. Example: Type 2 diabetes with nephropathy and neuropathy = E11.22 + E11.42.

FAQ

What is the difference between E11.9 and E11.65? E11.9 (Type 2 without complications) is used when patient has diabetes without any documented complications and without current hyperglycemia. E11.65 (Type 2 with hyperglycemia) is used when there is documented inadequately controlled diabetes or elevated blood glucose levels.

When should I code Z79.4 for insulin use? Code Z79.4 (Long-term current use of insulin) as an additional code when patient with Type 2 (E11) or secondary diabetes (E08, E09, E13) uses insulin. Do NOT assign Z79.4 with Type 1 (E10) because insulin use is inherent to Type 1.

Can I code E11 and E10 together? No. Per Excludes1 note, Type 1 and Type 2 codes are mutually exclusive. A patient cannot be coded as having both. If patient diagnosed with both types, clarification from provider is needed.

How do I code diabetes with multiple complications? Assign as many codes from diabetes category as necessary to describe all documented complications. Each complication should be captured with most specific code available. For example, Type 2 diabetes with nephropathy and neuropathy would receive both E11.22 and E11.42.

What is the correct code for "uncontrolled diabetes"? "Uncontrolled" diabetes should be coded as diabetes with hyperglycemia (x.65 code) unless documentation specifies hypoglycemia. Query provider if type of "uncontrolled" is unclear.

Is E11.9 billable? Yes, E11.9 (Type 2 without complications) is a billable code and appropriate when patient has Type 2 diabetes without any documented complications.

How do I code diabetes in pregnancy? Gestational diabetes is coded from category O24.4, not E10-E13. Pre-existing diabetes in pregnancy is coded using O24 category with additional codes from E10-E13 to identify the type.

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Last updated: January 2025. Code data reflects ICD-10-CM 2026 version.