ICD-10 E10.649
Billable / Specific HCC v28: 18Type 1 diabetes mellitus with hypoglycemia without coma
About ICD-10-CM E10.649
ICD-10-CM code E10.649 represents Type 1 diabetes mellitus with hypoglycemia without coma. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E10). The 2026 edition of ICD-10-CM E10.649 became effective on October 1, 2025.
Coding Tips for E10.649
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E10.649 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 E10.649
Local Coverage Determinations (LCDs) from CMS MACs that list E10.649 as a covered diagnosis.
Showing top 10 of 147 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E10.649.
5 Medicare
CPT Codes Commonly Billed with E10.649
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 E10.649 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 |
|---|---|---|
| E10.649 | 25081 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E10.649
Other codes in section E08-E13 (Diabetes mellitus).
ICD-10 E10.649, Billing FAQ
Is ICD-10 code E10.649 billable? +
Yes, E10.649 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does E10.649 affect Medicare Advantage HCC risk adjustment? +
Yes. E10.649 maps to CMS-HCC v28 category 18. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does E10.649 map to? +
Per CMS GEMs, E10.649 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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