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

ICD-10 E13.51

Billable / Specific HCC v28: 108

Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene

E13
Block
0
Synonyms
271
LCDs
42
Payer Policies
7
Linked CPTs

About ICD-10-CM E13.51

ICD-10-CM code E13.51 represents Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E13). The 2026 edition of ICD-10-CM E13.51 became effective on October 1, 2025.

Coding Tips for E13.51

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

E13.51 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

CMS-HCC v28 (current)
Category 108
ESRD-HCC
Category 108
RxHCC (Part D)
Category 108

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 E13.51

Local Coverage Determinations (LCDs) from CMS MACs that list E13.51 as a covered diagnosis.

271 LCDs

Showing top 10 of 271 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60318, Effective: , 409 covered, 1 non-covered
CPT 93926 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60318, Effective: , 409 covered, 1 non-covered
CPT 93930 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60318, Effective: , 409 covered, 1 non-covered
CPT 93925 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60318, Effective: , 409 covered, 1 non-covered
CPT 93931 →
CMS LCD: Billing and Coding: Magnesium
Article ID: 59186, Effective: 2025-10-01 00:00:00, 4358 covered, 0 non-covered
CPT 83735 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8918 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8936 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8910 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT 70548 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8913 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing E13.51.

42 policies

3 Cigna

Duplex Scan of Extracranial Arteries - (0542)
Policy ID: MM_0542
Electrical Stimulation Therapy and Devices in a Home Setting - (0160)
Policy ID: MM_0160
Orthotic Devices and Shoes - (0543)
Policy ID: MM_0543

5 Medicare

Glucose Monitor - Policy Article
Policy ID: ART-52464
Therapeutic Shoes for Persons with Diabetes - Policy Article
Policy ID: ART-52501
External Infusion Pumps - Policy Article
Policy ID: ART-52507
Billing and Coding: Routine Foot Care
Policy ID: ART-52996
Billing and Coding: Bariatric Surgery Coverage
Policy ID: ART-53026

CPT Codes Commonly Billed with E13.51

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

7 linkages
  • 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

Convert E13.51 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
E13.51 24970 10111
E13.51 25070 10111
E13.51 44381 10112

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To E13.51

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 E13.51, Billing FAQ

Is ICD-10 code E13.51 billable? +

Yes, E13.51 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does E13.51 affect Medicare Advantage HCC risk adjustment? +

Yes. E13.51 maps to CMS-HCC v28 category 108. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with E13.51? +

Procedures frequently paired with E13.51 include: 93922, 93931, 93923, 93930, 93925.

What ICD-9 codes does E13.51 map to? +

Per CMS GEMs, E13.51 maps to ICD-9 codes: 24970, 25070, 44381. 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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