ICD-10 E09.59
Billable / Specific HCC v28: 18Drug or chemical induced diabetes mellitus with other circulatory complications
About ICD-10-CM E09.59
ICD-10-CM code E09.59 represents Drug or chemical induced diabetes mellitus with other circulatory complications. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E09). The 2026 edition of ICD-10-CM E09.59 became effective on October 1, 2025.
Coding Tips for E09.59
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E09.59 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.
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 E09.59
Local Coverage Determinations (LCDs) from CMS MACs that list E09.59 as a covered diagnosis.
Showing top 10 of 179 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E09.59.
3 Cigna
5 Medicare
CPT Codes Commonly Billed with E09.59
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 93922 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 93931 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 93923 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 93930 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 93925 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 93926 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 93924 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
Convert E09.59 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 |
|---|---|---|
| E09.59 | 24970 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E09.59
Other codes in section E08-E13 (Diabetes mellitus).
ICD-10 E09.59, Billing FAQ
Is ICD-10 code E09.59 billable? +
Yes, E09.59 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does E09.59 affect Medicare Advantage HCC risk adjustment? +
Yes. E09.59 maps to CMS-HCC v28 category 18. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with E09.59? +
Procedures frequently paired with E09.59 include: 93922, 93931, 93923, 93930, 93925.
What ICD-9 codes does E09.59 map to? +
Per CMS GEMs, E09.59 maps to ICD-9 codes: 24970. 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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