ICD-10 E11.620
Billable / Specific HCC v28: 18Type 2 diabetes mellitus with diabetic dermatitis
About ICD-10-CM E11.620
ICD-10-CM code E11.620 represents Type 2 diabetes mellitus with diabetic dermatitis. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E11). The 2026 edition of ICD-10-CM E11.620 became effective on October 1, 2025.
Coding Tips for E11.620
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E11.620 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under E11.620. Per CMS ICD-10-CM Tabular 2026.
- Type 2 diabetes mellitus with diabetic necrobiosis lipoidica
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 E11.620
Local Coverage Determinations (LCDs) from CMS MACs that list E11.620 as a covered diagnosis.
Showing top 10 of 174 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E11.620.
5 Medicare
CPT Codes Commonly Billed with E11.620
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 E11.620 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 |
|---|---|---|
| E11.620 | 25080 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E11.620
Other codes in section E08-E13 (Diabetes mellitus).
ICD-10 E11.620, Billing FAQ
Is ICD-10 code E11.620 billable? +
Yes, E11.620 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 E11.620? +
ICD-10 E11.620 includes: Type 2 diabetes mellitus with diabetic necrobiosis lipoidica.
Does E11.620 affect Medicare Advantage HCC risk adjustment? +
Yes. E11.620 maps to CMS-HCC v28 category 18. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with E11.620? +
Procedures frequently paired with E11.620 include: 11006, 97607, 11008, 11005, 11012.
What ICD-9 codes does E11.620 map to? +
Per CMS GEMs, E11.620 maps to ICD-9 codes: 25080. 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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