ICD-10 E11.51
Billable / Specific HCC v28: 108Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
About ICD-10-CM E11.51
ICD-10-CM code E11.51 represents Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E11). The 2026 edition of ICD-10-CM E11.51 became effective on October 1, 2025.
Coding Tips for E11.51
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E11.51 is a CMS-HCC v28 risk-adjustment code (category 108). 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 E11.51
Local Coverage Determinations (LCDs) from CMS MACs that list E11.51 as a covered diagnosis.
Showing top 10 of 320 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E11.51.
3 Cigna
5 Medicare
CPT Codes Commonly Billed with E11.51
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
- 11047 CMS LCD: Billing and Coding: Debridement Services CMS LCD
- 11001 CMS LCD: Billing and Coding: Debridement Services CMS LCD
- 11046 CMS LCD: Billing and Coding: Debridement Services CMS LCD
Convert E11.51 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 |
|---|---|---|
| E11.51 | 25070 | 10111 |
| E11.51 | 44381 | 10112 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E11.51
Other codes in section E08-E13 (Diabetes mellitus).
ICD-10 E11.51, Billing FAQ
Is ICD-10 code E11.51 billable? +
Yes, E11.51 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does E11.51 affect Medicare Advantage HCC risk adjustment? +
Yes. E11.51 maps to CMS-HCC v28 category 108. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with E11.51? +
Procedures frequently paired with E11.51 include: 93922, 93931, 93923, 93930, 93925.
What ICD-9 codes does E11.51 map to? +
Per CMS GEMs, E11.51 maps to ICD-9 codes: 25070, 44381. Useful for legacy data review and historical claim analysis.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team