ICD-10 E10.621
Billable / Specific HCC v28: 161Type 1 diabetes mellitus with foot ulcer
About ICD-10-CM E10.621
ICD-10-CM code E10.621 represents Type 1 diabetes mellitus with foot ulcer. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E10). The 2026 edition of ICD-10-CM E10.621 became effective on October 1, 2025.
Coding Tips for E10.621
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E10.621 is a CMS-HCC v28 risk-adjustment code (category 161). 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 E10.621, also report these additional codes when applicable.
- code to identify site of ulcer (L97.4-, L97.5-)
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 E10.621
Local Coverage Determinations (LCDs) from CMS MACs that list E10.621 as a covered diagnosis.
Showing top 10 of 185 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E10.621.
5 Medicare
CPT Codes Commonly Billed with E10.621
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 11006 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 97607 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 11008 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 11005 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 11012 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 11010 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 97608 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 97610 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 11011 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 29581 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
Convert E10.621 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 |
|---|---|---|
| E10.621 | 25081 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E10.621
Other codes in section E08-E13 (Diabetes mellitus).
ICD-10 E10.621, Billing FAQ
Is ICD-10 code E10.621 billable? +
Yes, E10.621 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does E10.621 affect Medicare Advantage HCC risk adjustment? +
Yes. E10.621 maps to CMS-HCC v28 category 161. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with E10.621? +
Procedures frequently paired with E10.621 include: 11006, 97607, 11008, 11005, 11012.
What ICD-9 codes does E10.621 map to? +
Per CMS GEMs, E10.621 maps to ICD-9 codes: 25081. 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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