ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 E13

Non-Billable Header

Other specified diabetes mellitus

E13
Block
0
Synonyms
0
LCDs
3
Payer Policies
1
Linked CPTs

About ICD-10-CM E13

ICD-10-CM code E13 represents Other specified diabetes mellitus. This is a non-billable header code in the Endocrine, Nutritional, and Metabolic chapter (block E13). The 2026 edition of ICD-10-CM E13 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Type 1 Excludes

Pure excludes, these codes can never be coded together with E13. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • diabetes (mellitus) due to autoimmune process (E10.-)
  • diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)
  • diabetes mellitus due to underlying condition (E08.-)
  • drug or chemical induced diabetes mellitus (E09.-)
  • gestational diabetes (O24.4-)
  • neonatal diabetes mellitus (P70.2)
  • type 1 diabetes mellitus (E10.-)

Includes

  • diabetes mellitus due to genetic defects of beta-cell function
  • diabetes mellitus due to genetic defects in insulin action
  • postpancreatectomy diabetes mellitus
  • postprocedural diabetes mellitus
  • secondary diabetes mellitus NEC

Use Additional Code

When coding E13, also report these additional codes when applicable.

  • code to identify control using:
  • injectable non-insulin antidiabetic drugs (Z79.85)
  • insulin (Z79.4)
  • oral antidiabetic drugs (Z79.84)
  • oral hypoglycemic drugs (Z79.84)

Medicare LCD Coverage for E13

Local Coverage Determinations (LCDs) from CMS MACs that list E13 as a covered diagnosis.

No Medicare LCDs reference E13 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing E13.

3 policies

3 Cigna

Deep Brain, Motor Cortex and Responsive Cortical Stimulation - (0184)
Policy ID: MM_0184
Strapping and Taping - (CPG143)
Policy ID: CPG143_STRAPPING_TAPING
Ultrasound in Pregnancy (including 3D, 4D and 5D Ultrasound) - (0142)
Policy ID: MM_0142

CPT Codes Commonly Billed with E13

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

1 linkages
  • 80053 Comprehensive metabolic panel for diabetes management Internal Medicine

Codes Adjacent To E13

Other codes in section E08-E13 (Diabetes mellitus).

E08 Diabetes mellitus due to underlying condition (non-billable) E08.0 Diabetes mellitus due to underlying condition with hyperosmolarity (non-billable) E08.00 Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) E08.01 Diabetes mellitus due to underlying condition with hyperosmolarity with coma E08.1 Diabetes mellitus due to underlying condition with ketoacidosis (non-billable) E08.10 Diabetes mellitus due to underlying condition with ketoacidosis without coma E08.11 Diabetes mellitus due to underlying condition with ketoacidosis with coma E08.2 Diabetes mellitus due to underlying condition with kidney complications (non-billable) E08.21 Diabetes mellitus due to underlying condition with diabetic nephropathy E08.22 Diabetes mellitus due to underlying condition with diabetic chronic kidney disease E08.29 Diabetes mellitus due to underlying condition with other diabetic kidney complication E08.3 Diabetes mellitus due to underlying condition with ophthalmic complications (non-billable) E08.31 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy (non-billable) E08.311 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema E08.319 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema E08.32 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy (non-billable) E08.321 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema (non-billable) E08.329 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema (non-billable) E08.33 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy (non-billable) E08.331 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema (non-billable)

ICD-10 E13, Billing FAQ

Is ICD-10 code E13 billable? +

No, E13 is a non-billable header code. Use a more specific child code from block E13 when submitting claims.

What codes are Type 1 Excludes for E13? +

Type 1 Excludes (never code together with E13): diabetes (mellitus) due to autoimmune process (E10.-); diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-); diabetes mellitus due to underlying condition (E08.-)

What CPT codes are commonly billed with E13? +

Procedures frequently paired with E13 include: 80053.

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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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