ICD-10 E08.00
Billable / Specific HCC v28: 17 MCCDiabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
About ICD-10-CM E08.00
ICD-10-CM code E08.00 represents Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC). This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E08). The 2026 edition of ICD-10-CM E08.00 became effective on October 1, 2025.
Coding Tips for E08.00
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E08.00 is a CMS-HCC v28 risk-adjustment code (category 17). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
E08.00 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, MCC
0530:352 codes Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC). As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for E08.00
Local Coverage Determinations (LCDs) from CMS MACs that list E08.00 as a covered diagnosis.
Showing top 10 of 67 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E08.00.
3 Aetna
5 Medicare
CPT Codes Commonly Billed with E08.00
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 0448T CMS LCD: Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) CMS LCD
- 0446T CMS LCD: Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) CMS LCD
- 0447T CMS LCD: Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) CMS LCD
- 43889 CMS LCD: Billing and Coding: Laparoscopic Sleeve Gastrectomy for Severe Obesity CMS LCD
Convert E08.00 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| E08.00 | 24920 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E08.00
Other codes in section E08-E13 (Diabetes mellitus).
ICD-10 E08.00, Billing FAQ
Is ICD-10 code E08.00 billable? +
Yes, E08.00 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does E08.00 affect Medicare Advantage HCC risk adjustment? +
Yes. E08.00 maps to CMS-HCC v28 category 17. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is E08.00 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with E08.00? +
Procedures frequently paired with E08.00 include: 0448T, 0446T, 0447T, 43889.
What ICD-9 codes does E08.00 map to? +
Per CMS GEMs, E08.00 maps to ICD-9 codes: 24920. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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