ICD-10 E08.69
Billable / Specific HCC v28: 18Diabetes mellitus due to underlying condition with other specified complication
About ICD-10-CM E08.69
ICD-10-CM code E08.69 represents Diabetes mellitus due to underlying condition with other specified complication. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E08). The 2026 edition of ICD-10-CM E08.69 became effective on October 1, 2025.
Coding Tips for E08.69
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E08.69 is a CMS-HCC v28 risk-adjustment code (category 18). 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.
Use Additional Code
When coding E08.69, also report these additional codes when applicable.
- code to identify complication
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.
Medicare LCD Coverage for E08.69
Local Coverage Determinations (LCDs) from CMS MACs that list E08.69 as a covered diagnosis.
Showing top 10 of 62 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E08.69.
5 Medicare
CPT Codes Commonly Billed with E08.69
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert E08.69 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 |
|---|---|---|
| E08.69 | 24980 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E08.69
Other codes in section E08-E13 (Diabetes mellitus).
ICD-10 E08.69, Billing FAQ
Is ICD-10 code E08.69 billable? +
Yes, E08.69 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does E08.69 affect Medicare Advantage HCC risk adjustment? +
Yes. E08.69 maps to CMS-HCC v28 category 18. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does E08.69 map to? +
Per CMS GEMs, E08.69 maps to ICD-9 codes: 24980. 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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