ICD-10 E11.21
Billable / SpecificType 2 diabetes mellitus with diabetic nephropathy
About ICD-10-CM E11.21
ICD-10-CM code E11.21 represents Type 2 diabetes mellitus with diabetic nephropathy. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E11). The 2026 edition of ICD-10-CM E11.21 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under E11.21. Per CMS ICD-10-CM Tabular 2026.
- Type 2 diabetes mellitus with intercapillary glomerulosclerosis
- Type 2 diabetes mellitus with intracapillary glomerulonephrosis
- Type 2 diabetes mellitus with Kimmelstiel-Wilson disease
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 E11.21
Local Coverage Determinations (LCDs) from CMS MACs that list E11.21 as a covered diagnosis.
Showing top 10 of 244 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E11.21.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with E11.21
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 83036 Hemoglobin A1c — type 2 diabetes, type 1 diabetes, prediabetes, diabetes screening, diabetic kidney disease, diabetic retinopathy Laboratory
- 43645 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43888 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43845 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43848 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43772 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43659 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43644 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43774 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43775 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
Convert E11.21 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 |
|---|---|---|
| E11.21 | 25040 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E11.21
Other codes in section E08-E13 (Diabetes mellitus).
ICD-10 E11.21, Billing FAQ
Is ICD-10 code E11.21 billable? +
Yes, E11.21 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to E11.21? +
ICD-10 E11.21 includes: Type 2 diabetes mellitus with intercapillary glomerulosclerosis; Type 2 diabetes mellitus with intracapillary glomerulonephrosis; Type 2 diabetes mellitus with Kimmelstiel-Wilson disease.
What CPT codes are commonly billed with E11.21? +
Procedures frequently paired with E11.21 include: 83036, 43645, 43888, 43845, 43848.
What ICD-9 codes does E11.21 map to? +
Per CMS GEMs, E11.21 maps to ICD-9 codes: 25040. 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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