Diabetes mellitus due to underlying condition
In Diabetes mellitus (E08-E13), chapter 4: Endocrine, Nutritional and Metabolic Diseases
86 billable codes under E08: 5 are an MCC, 1 is a CC; all map to HCC 37 (Diabetes with Chronic Complications), HCC 298 (Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage), HCC 36 (Diabetes with Severe Acute Complications) and 3 more HCCs.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
Advertisements
Instructional notes
Excludes1: not coded here, use a different code
- drug or chemical induced diabetes mellitus (E09.-)
- gestational diabetes (O24.4-)
- neonatal diabetes mellitus (P70.2)
- postpancreatectomy diabetes mellitus (E13.-)
- postprocedural diabetes mellitus (E13.-)
- secondary diabetes mellitus NEC (E13.-)
- type 1 diabetes mellitus (E10.-)
- type 2 diabetes mellitus (E11.-)
Code first: code the underlying condition first, then this code
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
- Section I.C.4.a Diabetes mellitus (page 39), covers E08
Assign as many codes from E08 to E13 as needed for all complications; default to E11.- when type is undocumented. Add Z79 codes for long-term insulin, oral, or injectable drugs, but not Z79.4 for temporary insulin.
Other Chapter 4 topics:
- Obesity (page 42)
All codes under E08
E08 can't be used on a claim. Pick a billable code below; grey headings group them.
- E08.0Diabetes mellitus due to underlying condition with hyperosmolarity
- E08.00Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
- E08.01Diabetes mellitus due to underlying condition with hyperosmolarity with coma
- E08.1Diabetes mellitus due to underlying condition with ketoacidosis
- E08.10Diabetes mellitus due to underlying condition with ketoacidosis without coma
- E08.11Diabetes mellitus due to underlying condition with ketoacidosis with coma
- E08.2Diabetes mellitus due to underlying condition with kidney complications
- E08.21Diabetes mellitus due to underlying condition with diabetic nephropathy
- E08.22Diabetes mellitus due to underlying condition with diabetic chronic kidney disease
- E08.29Diabetes mellitus due to underlying condition with other diabetic kidney complication
- E08.3Diabetes mellitus due to underlying condition with ophthalmic complications
- E08.31Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy
- E08.311Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema
- E08.319Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema
- E08.32Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy
- E08.321Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema
- E08.3211Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye
- E08.3212Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye
- E08.3213Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral
- E08.3219Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
- E08.329Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema
- E08.3291Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right eye
- E08.3292Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, left eye
- E08.3293Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, bilateral
- E08.3299Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
- E08.33Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy
- E08.331Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema
- E08.3311Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye
- E08.3312Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left eye
- E08.3313Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
- E08.3319Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
- E08.339Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema
- E08.3391Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right eye
- E08.3392Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, left eye
- E08.3393Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
- E08.3399Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
- E08.34Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy
- E08.341Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema
- E08.3411Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye
- E08.3412Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left eye
- E08.3413Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral
- E08.3419Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
- E08.349Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema
- E08.3491Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right eye
- E08.3492Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, left eye
- E08.3493Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, bilateral
- E08.3499Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
- E08.35Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy
- E08.351Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema
- E08.3511Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye
- E08.3512Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eye
- E08.3513Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral
- E08.3519Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, unspecified eye
- E08.352Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula
- E08.3521Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
- E08.3522Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
- E08.3523Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
- E08.3529Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
- E08.353Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula
- E08.3531Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
- E08.3532Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
- E08.3533Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
- E08.3539Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
- E08.354Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
- E08.3541Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
- E08.3542Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
- E08.3543Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
- E08.3549Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
- E08.355Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy
- E08.3551Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye
- E08.3552Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eye
- E08.3553Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral
- E08.3559Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, unspecified eye
- E08.359Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema
- E08.3591Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye
- E08.3592Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eye
- E08.3593Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral
- E08.3599Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, unspecified eye
- E08.36Diabetes mellitus due to underlying condition with diabetic cataract
- E08.37Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment
- E08.37X1Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right eye
- E08.37X2Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, left eye
- E08.37X3Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, bilateral
- E08.37X9Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, unspecified eye
- E08.39Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication
- E08.4Diabetes mellitus due to underlying condition with neurological complications
- E08.40Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified
- E08.41Diabetes mellitus due to underlying condition with diabetic mononeuropathy
- E08.42Diabetes mellitus due to underlying condition with diabetic polyneuropathy
- E08.43Diabetes mellitus due to underlying condition with diabetic autonomic (poly)neuropathy
- E08.44Diabetes mellitus due to underlying condition with diabetic amyotrophy
- E08.49Diabetes mellitus due to underlying condition with other diabetic neurological complication
- E08.5Diabetes mellitus due to underlying condition with circulatory complications
- E08.51Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy without gangrene
- E08.52Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene
- E08.59Diabetes mellitus due to underlying condition with other circulatory complications
- E08.6Diabetes mellitus due to underlying condition with other specified complications
- E08.61Diabetes mellitus due to underlying condition with diabetic arthropathy
- E08.610Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy
- E08.618Diabetes mellitus due to underlying condition with other diabetic arthropathy
- E08.62Diabetes mellitus due to underlying condition with skin complications
- E08.620Diabetes mellitus due to underlying condition with diabetic dermatitis
- E08.621Diabetes mellitus due to underlying condition with foot ulcer
- E08.622Diabetes mellitus due to underlying condition with other skin ulcer
- E08.628Diabetes mellitus due to underlying condition with other skin complications
- E08.63Diabetes mellitus due to underlying condition with oral complications
- E08.630Diabetes mellitus due to underlying condition with periodontal disease
- E08.638Diabetes mellitus due to underlying condition with other oral complications
- E08.64Diabetes mellitus due to underlying condition with hypoglycemia
- E08.641Diabetes mellitus due to underlying condition with hypoglycemia with coma
- E08.649Diabetes mellitus due to underlying condition with hypoglycemia without coma
- E08.65Diabetes mellitus due to underlying condition with hyperglycemia
- E08.69Diabetes mellitus due to underlying condition with other specified complication
- E08.8Diabetes mellitus due to underlying condition with unspecified complications
- E08.9Diabetes mellitus due to underlying condition without complications
E08 MS-DRGs
As the principal diagnosis, the billable codes under E08 group to these 16 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 073 Cranial and Peripheral Nerve Disorders with MCC (1 of 86 codes)
- DRG 074 Cranial and Peripheral Nerve Disorders without MCC (1 of 86 codes)
- DRG 124 Other Disorders of the Eye with MCC or Thrombolytic Agent (1 of 86 codes)
- DRG 125 Other Disorders of the Eye without MCC (1 of 86 codes)
- DRG 299 Peripheral Vascular Disorders with MCC (1 of 86 codes)
- DRG 300 Peripheral Vascular Disorders with CC (1 of 86 codes)
- DRG 301 Peripheral Vascular Disorders without CC/MCC (1 of 86 codes)
- DRG 637 Diabetes with MCC (1 of 86 codes)
- DRG 638 Diabetes with CC (1 of 86 codes)
- DRG 639 Diabetes without CC/MCC (1 of 86 codes)
- DRG 673 Other Kidney and Urinary Tract Procedures with MCC (1 of 86 codes)
- DRG 674 Other Kidney and Urinary Tract Procedures with CC (1 of 86 codes)
- DRG 675 Other Kidney and Urinary Tract Procedures without CC/MCC (1 of 86 codes)
- DRG 698 Other Kidney and Urinary Tract Diagnoses with MCC (1 of 86 codes)
- DRG 699 Other Kidney and Urinary Tract Diagnoses with CC (1 of 86 codes)
- DRG 700 Other Kidney and Urinary Tract Diagnoses without CC/MCC (1 of 86 codes)
Other codes that refer to E08
Notes on these codes point to E08.
- D84.81 Code First: diabetes mellitus (E08-E13)
- E09 Excludes1: diabetes mellitus due to underlying condition (E08.-)
- E10 Excludes1: diabetes mellitus due to underlying condition (E08.-)
- E11 Excludes1: diabetes mellitus due to underlying condition (E08.-)
- E13 Excludes1: diabetes mellitus due to underlying condition (E08.-)
- E74 Excludes1: diabetes mellitus (E08-E13)
- E87.0 Excludes2: diabetes with hyperosmolarity (E08, E09, E11, E13 with final characters .00 or .01)
- E87.2 Excludes1: diabetic acidosis - see categories E08-E10, E11, E13 with ketoacidosis
- G54.5 Excludes1: neuralgic amyotrophy in diabetes mellitus (E08-E13 with .44)
- G59 Excludes1: diabetic mononeuropathy (E08-E13 with .41)
- G63 Excludes1: diabetes mellitus (E08-E13 with .42)
- G99.0 Excludes1: diabetic autonomic neuropathy (E08-E13 with .43)
- H20.0 Excludes1: iridocyclitis, iritis, uveitis (due to) (in) diabetes mellitus (E08-E13 with .39)
- I73.8 Excludes1: diabetic (peripheral) angiopathy (E08-E13 with .51-.52)
- I79.8 Excludes1: diabetic (peripheral) angiopathy (E08-E13 with .51-.52)
- I96 Excludes2: gangrene in diabetes mellitus (E08-E13 with .52)
- L92.1 Excludes1: necrobiosis lipoidica associated with diabetes mellitus (E08-E13 with .620)
- L99 Excludes1: skin disorders in diabetes (E08-E13 with .62-)
- M14 Excludes1: diabetes mellitus (E08-E13 with .61-)
- M14.6 Excludes1: Charcôt's joint in diabetes mellitus (E08-E13 with .610)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Diabetes
Diabetes, also known as diabetes mellitus, is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your body's main source of energy. Your body can make glucose, but it also comes from the food you eat. Insulin is a hormone made by your pancreas. Insulin helps move glucose from your bloodstream into your cells, where it can be used for energy.
Read more about diabetes on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
