PCM · Endocrinology
PCM Qualifying Diagnoses
for Endocrinology.
564 ICD-10-CM codes cover endocrinology patients for Principal Care Management (PCM).
Qualifying Codes
ICD-10 codes for endocrinology.
Endocrine and metabolic
Type 2 diabetes mellitus
E1187 codesrpmccmpcmBlood glucose by meter or CGM, commonly paired with blood pressure and weight because the comorbidities travel together.
Type 2 diabetes mellitus
E1187 codesrpmccmpcmCMS chronic condition · CCW category: Diabetes · Devices: Blood glucose meter, Continuous glucose monitor, Blood pressure cuff, Connected weight scale
Code to the complication. E11.9 (without complications) is accurate only when the record truly documents none, and it carries no HCC weight.
Read the type 2 diabetes mellitus monitoring guide
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| E11.00 | Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E11.01 | Type 2 diabetes mellitus with hyperosmolarity with coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E11.10 | Type 2 diabetes mellitus with ketoacidosis without coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E11.11 | Type 2 diabetes mellitus with ketoacidosis with coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E11.21 | Type 2 diabetes mellitus with diabetic nephropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.22 | Type 2 diabetes mellitus with diabetic chronic kidney disease | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.29 | Type 2 diabetes mellitus with other diabetic kidney complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.311 | Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.319 | Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3211 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3212 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3213 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3219 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3291 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3292 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3293 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3299 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3311 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3312 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3313 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3319 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3391 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3392 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3393 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3399 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3411 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3412 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3413 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3419 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3491 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3492 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3493 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3499 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3511 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3512 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3513 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3519 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3521 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3522 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3523 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3529 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3531 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3532 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3533 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3539 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3541 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3542 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3543 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3549 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3551 | Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3552 | Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3553 | Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3559 | Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3591 | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3592 | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3593 | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.3599 | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.36 | Type 2 diabetes mellitus with diabetic cataract | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.37X1 | Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.37X2 | Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.37X3 | Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.37X9 | Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.39 | Type 2 diabetes mellitus with other diabetic ophthalmic complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.40 | Type 2 diabetes mellitus with diabetic neuropathy, unspecified | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.41 | Type 2 diabetes mellitus with diabetic mononeuropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.42 | Type 2 diabetes mellitus with diabetic polyneuropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.43 | Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.44 | Type 2 diabetes mellitus with diabetic amyotrophy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.49 | Type 2 diabetes mellitus with other diabetic neurological complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.51 | Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.52 | Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.59 | Type 2 diabetes mellitus with other circulatory complications | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.610 | Type 2 diabetes mellitus with diabetic neuropathic arthropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.618 | Type 2 diabetes mellitus with other diabetic arthropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.620 | Type 2 diabetes mellitus with diabetic dermatitis | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.621 | Type 2 diabetes mellitus with foot ulcer | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.622 | Type 2 diabetes mellitus with other skin ulcer | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.628 | Type 2 diabetes mellitus with other skin complications | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.630 | Type 2 diabetes mellitus with periodontal disease | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.638 | Type 2 diabetes mellitus with other oral complications | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.641 | Type 2 diabetes mellitus with hypoglycemia with coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E11.649 | Type 2 diabetes mellitus with hypoglycemia without coma | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E11.65 | Type 2 diabetes mellitus with hyperglycemia | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E11.69 | Type 2 diabetes mellitus with other specified complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E11.8 | Type 2 diabetes mellitus with unspecified complications | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E11.9 | Type 2 diabetes mellitus without complications | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E11.A | Type 2 diabetes mellitus without complications in remission | rpmccmpcm | not risk adjusted |
Type 1 diabetes mellitus
E1087 codesrpmccmpcmCGM trend and time-in-range review, with meter confirmation where CGM is not in use.
Type 1 diabetes mellitus
E1087 codesrpmccmpcmCMS chronic condition · CCW category: Diabetes · Devices: Continuous glucose monitor, Blood glucose meter
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| E10.10 | Type 1 diabetes mellitus with ketoacidosis without coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E10.11 | Type 1 diabetes mellitus with ketoacidosis with coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E10.21 | Type 1 diabetes mellitus with diabetic nephropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.22 | Type 1 diabetes mellitus with diabetic chronic kidney disease | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.29 | Type 1 diabetes mellitus with other diabetic kidney complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.311 | Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.319 | Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3211 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3212 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3213 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3219 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3291 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3292 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3293 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3299 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3311 | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3312 | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3313 | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3319 | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3391 | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3392 | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3393 | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3399 | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3411 | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3412 | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3413 | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3419 | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3491 | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3492 | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3493 | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3499 | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3511 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3512 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3513 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3519 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3521 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3522 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3523 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3529 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3531 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3532 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3533 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3539 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3541 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3542 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3543 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3549 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3551 | Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3552 | Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3553 | Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3559 | Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3591 | Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3592 | Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3593 | Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.3599 | Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.36 | Type 1 diabetes mellitus with diabetic cataract | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.37X1 | Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.37X2 | Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.37X3 | Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.37X9 | Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.39 | Type 1 diabetes mellitus with other diabetic ophthalmic complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.40 | Type 1 diabetes mellitus with diabetic neuropathy, unspecified | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.41 | Type 1 diabetes mellitus with diabetic mononeuropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.42 | Type 1 diabetes mellitus with diabetic polyneuropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.43 | Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.44 | Type 1 diabetes mellitus with diabetic amyotrophy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.49 | Type 1 diabetes mellitus with other diabetic neurological complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.51 | Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.52 | Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.59 | Type 1 diabetes mellitus with other circulatory complications | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.610 | Type 1 diabetes mellitus with diabetic neuropathic arthropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.618 | Type 1 diabetes mellitus with other diabetic arthropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.620 | Type 1 diabetes mellitus with diabetic dermatitis | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.621 | Type 1 diabetes mellitus with foot ulcer | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.622 | Type 1 diabetes mellitus with other skin ulcer | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.628 | Type 1 diabetes mellitus with other skin complications | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.630 | Type 1 diabetes mellitus with periodontal disease | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.638 | Type 1 diabetes mellitus with other oral complications | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.641 | Type 1 diabetes mellitus with hypoglycemia with coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E10.649 | Type 1 diabetes mellitus with hypoglycemia without coma | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E10.65 | Type 1 diabetes mellitus with hyperglycemia | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E10.69 | Type 1 diabetes mellitus with other specified complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E10.8 | Type 1 diabetes mellitus with unspecified complications | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E10.9 | Type 1 diabetes mellitus without complications | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E10.A0 | Type 1 diabetes mellitus, presymptomatic, unspecifiedlow specificity | rpmccmpcm | not risk adjusted |
| E10.A1 | Type 1 diabetes mellitus, presymptomatic, Stage 1 | rpmccmpcm | not risk adjusted |
| E10.A2 | Type 1 diabetes mellitus, presymptomatic, Stage 2 | rpmccmpcm | not risk adjusted |
Diabetes due to underlying condition, drugs or chemicals
E08, E09, E13258 codesrpmccmpcmGlucose monitoring during and after the exposure or treatment that caused the hyperglycemia.
Diabetes due to underlying condition, drugs or chemicals
E08, E09, E13258 codesrpmccmpcmCMS chronic condition · CCW category: Diabetes · Devices: Blood glucose meter, Continuous glucose monitor
E08 and E09 require the underlying condition or the drug to be coded first. Steroid-induced hyperglycemia belongs in E09, not E11.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| E08.00 | Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E08.01 | Diabetes mellitus due to underlying condition with hyperosmolarity with coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E08.10 | Diabetes mellitus due to underlying condition with ketoacidosis without coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E08.11 | Diabetes mellitus due to underlying condition with ketoacidosis with coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E08.21 | Diabetes mellitus due to underlying condition with diabetic nephropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.22 | Diabetes mellitus due to underlying condition with diabetic chronic kidney disease | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.29 | Diabetes mellitus due to underlying condition with other diabetic kidney complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.311 | Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.319 | Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3211 | Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3212 | Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3213 | Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3219 | Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3291 | Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3292 | Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3293 | Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3299 | Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3311 | Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3312 | Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3313 | Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3319 | Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3391 | Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3392 | Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3393 | Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3399 | Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3411 | Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3412 | Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3413 | Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3419 | Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3491 | Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3492 | Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3493 | Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3499 | Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3511 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3512 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3513 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3519 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3521 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3522 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3523 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3529 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3531 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3532 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3533 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3539 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3541 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3542 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3543 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3549 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3551 | Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3552 | Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3553 | Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3559 | Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3591 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3592 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3593 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.3599 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.36 | Diabetes mellitus due to underlying condition with diabetic cataract | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.37X1 | Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.37X2 | Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.37X3 | Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.37X9 | Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.39 | Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.40 | Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.41 | Diabetes mellitus due to underlying condition with diabetic mononeuropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.42 | Diabetes mellitus due to underlying condition with diabetic polyneuropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.43 | Diabetes mellitus due to underlying condition with diabetic autonomic (poly)neuropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.44 | Diabetes mellitus due to underlying condition with diabetic amyotrophy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.49 | Diabetes mellitus due to underlying condition with other diabetic neurological complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.51 | Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy without gangrene | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.52 | Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.59 | Diabetes mellitus due to underlying condition with other circulatory complications | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.610 | Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.618 | Diabetes mellitus due to underlying condition with other diabetic arthropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.620 | Diabetes mellitus due to underlying condition with diabetic dermatitis | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.621 | Diabetes mellitus due to underlying condition with foot ulcer | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.622 | Diabetes mellitus due to underlying condition with other skin ulcer | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.628 | Diabetes mellitus due to underlying condition with other skin complications | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.630 | Diabetes mellitus due to underlying condition with periodontal disease | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.638 | Diabetes mellitus due to underlying condition with other oral complications | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.641 | Diabetes mellitus due to underlying condition with hypoglycemia with coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E08.649 | Diabetes mellitus due to underlying condition with hypoglycemia without coma | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E08.65 | Diabetes mellitus due to underlying condition with hyperglycemia | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E08.69 | Diabetes mellitus due to underlying condition with other specified complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E08.8 | Diabetes mellitus due to underlying condition with unspecified complications | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E08.9 | Diabetes mellitus due to underlying condition without complications | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E09.00 | Drug or chemical induced diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) | rpmccmpcm | not risk adjusted |
| E09.01 | Drug or chemical induced diabetes mellitus with hyperosmolarity with coma | rpmccmpcm | not risk adjusted |
| E09.10 | Drug or chemical induced diabetes mellitus with ketoacidosis without coma | rpmccmpcm | not risk adjusted |
| E09.11 | Drug or chemical induced diabetes mellitus with ketoacidosis with coma | rpmccmpcm | not risk adjusted |
| E09.21 | Drug or chemical induced diabetes mellitus with diabetic nephropathy | rpmccmpcm | not risk adjusted |
| E09.22 | Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease | rpmccmpcm | not risk adjusted |
| E09.29 | Drug or chemical induced diabetes mellitus with other diabetic kidney complication | rpmccmpcm | not risk adjusted |
| E09.311 | Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema | rpmccmpcm | not risk adjusted |
| E09.319 | Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy without macular edema | rpmccmpcm | not risk adjusted |
| E09.3211 | Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | not risk adjusted |
| E09.3212 | Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | not risk adjusted |
| E09.3213 | Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | not risk adjusted |
| E09.3219 | Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.3291 | Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | not risk adjusted |
| E09.3292 | Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | not risk adjusted |
| E09.3293 | Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | not risk adjusted |
| E09.3299 | Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.3311 | Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | not risk adjusted |
| E09.3312 | Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | not risk adjusted |
| E09.3313 | Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | not risk adjusted |
| E09.3319 | Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.3391 | Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | not risk adjusted |
| E09.3392 | Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | not risk adjusted |
| E09.3393 | Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | not risk adjusted |
| E09.3399 | Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.3411 | Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | not risk adjusted |
| E09.3412 | Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | not risk adjusted |
| E09.3413 | Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | not risk adjusted |
| E09.3419 | Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.3491 | Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | not risk adjusted |
| E09.3492 | Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | not risk adjusted |
| E09.3493 | Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | not risk adjusted |
| E09.3499 | Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.3511 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | not risk adjusted |
| E09.3512 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | not risk adjusted |
| E09.3513 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | not risk adjusted |
| E09.3519 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.3521 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye | rpmccmpcm | not risk adjusted |
| E09.3522 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye | rpmccmpcm | not risk adjusted |
| E09.3523 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral | rpmccmpcm | not risk adjusted |
| E09.3529 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.3531 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye | rpmccmpcm | not risk adjusted |
| E09.3532 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye | rpmccmpcm | not risk adjusted |
| E09.3533 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral | rpmccmpcm | not risk adjusted |
| E09.3539 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.3541 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye | rpmccmpcm | not risk adjusted |
| E09.3542 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye | rpmccmpcm | not risk adjusted |
| E09.3543 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral | rpmccmpcm | not risk adjusted |
| E09.3549 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.3551 | Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, right eye | rpmccmpcm | not risk adjusted |
| E09.3552 | Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, left eye | rpmccmpcm | not risk adjusted |
| E09.3553 | Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, bilateral | rpmccmpcm | not risk adjusted |
| E09.3559 | Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.3591 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | not risk adjusted |
| E09.3592 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | not risk adjusted |
| E09.3593 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | not risk adjusted |
| E09.3599 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.36 | Drug or chemical induced diabetes mellitus with diabetic cataract | rpmccmpcm | not risk adjusted |
| E09.37X1 | Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, right eye | rpmccmpcm | not risk adjusted |
| E09.37X2 | Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, left eye | rpmccmpcm | not risk adjusted |
| E09.37X3 | Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral | rpmccmpcm | not risk adjusted |
| E09.37X9 | Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye | rpmccmpcm | not risk adjusted |
| E09.39 | Drug or chemical induced diabetes mellitus with other diabetic ophthalmic complication | rpmccmpcm | not risk adjusted |
| E09.40 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic neuropathy, unspecified | rpmccmpcm | not risk adjusted |
| E09.41 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy | rpmccmpcm | not risk adjusted |
| E09.42 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy | rpmccmpcm | not risk adjusted |
| E09.43 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic autonomic (poly)neuropathy | rpmccmpcm | not risk adjusted |
| E09.44 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy | rpmccmpcm | not risk adjusted |
| E09.49 | Drug or chemical induced diabetes mellitus with neurological complications with other diabetic neurological complication | rpmccmpcm | not risk adjusted |
| E09.51 | Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy without gangrene | rpmccmpcm | not risk adjusted |
| E09.52 | Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene | rpmccmpcm | not risk adjusted |
| E09.59 | Drug or chemical induced diabetes mellitus with other circulatory complications | rpmccmpcm | not risk adjusted |
| E09.610 | Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy | rpmccmpcm | not risk adjusted |
| E09.618 | Drug or chemical induced diabetes mellitus with other diabetic arthropathy | rpmccmpcm | not risk adjusted |
| E09.620 | Drug or chemical induced diabetes mellitus with diabetic dermatitis | rpmccmpcm | not risk adjusted |
| E09.621 | Drug or chemical induced diabetes mellitus with foot ulcer | rpmccmpcm | not risk adjusted |
| E09.622 | Drug or chemical induced diabetes mellitus with other skin ulcer | rpmccmpcm | not risk adjusted |
| E09.628 | Drug or chemical induced diabetes mellitus with other skin complications | rpmccmpcm | not risk adjusted |
| E09.630 | Drug or chemical induced diabetes mellitus with periodontal disease | rpmccmpcm | not risk adjusted |
| E09.638 | Drug or chemical induced diabetes mellitus with other oral complications | rpmccmpcm | not risk adjusted |
| E09.641 | Drug or chemical induced diabetes mellitus with hypoglycemia with coma | rpmccmpcm | not risk adjusted |
| E09.649 | Drug or chemical induced diabetes mellitus with hypoglycemia without coma | rpmccmpcm | not risk adjusted |
| E09.65 | Drug or chemical induced diabetes mellitus with hyperglycemia | rpmccmpcm | not risk adjusted |
| E09.69 | Drug or chemical induced diabetes mellitus with other specified complication | rpmccmpcm | not risk adjusted |
| E09.8 | Drug or chemical induced diabetes mellitus with unspecified complications | rpmccmpcm | not risk adjusted |
| E09.9 | Drug or chemical induced diabetes mellitus without complications | rpmccmpcm | not risk adjusted |
| E13.00 | Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E13.01 | Other specified diabetes mellitus with hyperosmolarity with coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E13.10 | Other specified diabetes mellitus with ketoacidosis without coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E13.11 | Other specified diabetes mellitus with ketoacidosis with coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E13.21 | Other specified diabetes mellitus with diabetic nephropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.22 | Other specified diabetes mellitus with diabetic chronic kidney disease | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.29 | Other specified diabetes mellitus with other diabetic kidney complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.311 | Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.319 | Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3211 | Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3212 | Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3213 | Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3219 | Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3291 | Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3292 | Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3293 | Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3299 | Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3311 | Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3312 | Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3313 | Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3319 | Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3391 | Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3392 | Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3393 | Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3399 | Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3411 | Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3412 | Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3413 | Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3419 | Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3491 | Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3492 | Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3493 | Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3499 | Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3511 | Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3512 | Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3513 | Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3519 | Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3521 | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3522 | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3523 | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3529 | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3531 | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3532 | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3533 | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3539 | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3541 | Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3542 | Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3543 | Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3549 | Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3551 | Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3552 | Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3553 | Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3559 | Other specified diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3591 | Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3592 | Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3593 | Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.3599 | Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.36 | Other specified diabetes mellitus with diabetic cataract | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.37X1 | Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.37X2 | Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, left eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.37X3 | Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.37X9 | Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.39 | Other specified diabetes mellitus with other diabetic ophthalmic complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.40 | Other specified diabetes mellitus with diabetic neuropathy, unspecified | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.41 | Other specified diabetes mellitus with diabetic mononeuropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.42 | Other specified diabetes mellitus with diabetic polyneuropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.43 | Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.44 | Other specified diabetes mellitus with diabetic amyotrophy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.49 | Other specified diabetes mellitus with other diabetic neurological complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.51 | Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.52 | Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.59 | Other specified diabetes mellitus with other circulatory complications | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.610 | Other specified diabetes mellitus with diabetic neuropathic arthropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.618 | Other specified diabetes mellitus with other diabetic arthropathy | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.620 | Other specified diabetes mellitus with diabetic dermatitis | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.621 | Other specified diabetes mellitus with foot ulcer | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.622 | Other specified diabetes mellitus with other skin ulcer | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.628 | Other specified diabetes mellitus with other skin complications | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.630 | Other specified diabetes mellitus with periodontal disease | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.638 | Other specified diabetes mellitus with other oral complications | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.641 | Other specified diabetes mellitus with hypoglycemia with coma | rpmccmpcm | HCC 36 · Diabetes with Severe Acute Complications |
| E13.649 | Other specified diabetes mellitus with hypoglycemia without coma | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E13.65 | Other specified diabetes mellitus with hyperglycemia | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E13.69 | Other specified diabetes mellitus with other specified complication | rpmccmpcm | HCC 37 · Diabetes with Chronic Complications |
| E13.8 | Other specified diabetes mellitus with unspecified complications | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
| E13.9 | Other specified diabetes mellitus without complications | rpmccmpcm | HCC 38 · Diabetes with Glycemic, Unspecified, or No Complications |
Other endocrine, nutritional and metabolic disorders
E15, E16, E20, E21, E22, E23, E24, E26, E27, E83, E86, E87, E88132 codesccmpcmDepends on the disorder. Hypoglycemia and electrolyte disorders are the ones that most often justify device data.
Other endocrine, nutritional and metabolic disorders
E15, E16, E20, E21, E22, E23, E24, E26, E27, E83, E86, E87, E88132 codesccmpcmAdded by CCN Health · Devices: Blood glucose meter, Connected weight scale
E88.81 is no longer valid on its own. Metabolic syndrome is now E88.810.
Effective 2026-10-01: E89.830 and E89.838 arrive on 2026-10-01 for post-bariatric hypoglycemia.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| E15 | Nondiabetic hypoglycemic coma | ccmpcm | not risk adjusted |
| E16.0 | Drug-induced hypoglycemia without coma | ccmpcm | not risk adjusted |
| E16.1 | Other hypoglycemia | ccmpcm | not risk adjusted |
| E16.2 | Hypoglycemia, unspecified | ccmpcm | not risk adjusted |
| E16.3 | Increased secretion of glucagon | ccmpcm | not risk adjusted |
| E16.4 | Increased secretion of gastrin | ccmpcm | not risk adjusted |
| E16.8 | Other specified disorders of pancreatic internal secretion | ccmpcm | not risk adjusted |
| E16.9 | Disorder of pancreatic internal secretion, unspecified | ccmpcm | not risk adjusted |
| E16.A1 | Hypoglycemia level 1 | ccmpcm | not risk adjusted |
| E16.A2 | Hypoglycemia level 2 | ccmpcm | not risk adjusted |
| E16.A3 | Hypoglycemia level 3 | ccmpcm | not risk adjusted |
| E20.0 | Idiopathic hypoparathyroidism | ccmpcm | not risk adjusted |
| E20.1 | Pseudohypoparathyroidism | ccmpcm | not risk adjusted |
| E20.810 | Autosomal dominant hypocalcemia | ccmpcm | not risk adjusted |
| E20.811 | Secondary hypoparathyroidism in diseases classified elsewhere | ccmpcm | not risk adjusted |
| E20.812 | Autoimmune hypoparathyroidism | ccmpcm | not risk adjusted |
| E20.818 | Other specified hypoparathyroidism due to impaired parathyroid hormone secretion | ccmpcm | not risk adjusted |
| E20.819 | Hypoparathyroidism due to impaired parathyroid hormone secretion, unspecified | ccmpcm | not risk adjusted |
| E20.89 | Other specified hypoparathyroidism | ccmpcm | not risk adjusted |
| E20.9 | Hypoparathyroidism, unspecified | ccmpcm | not risk adjusted |
| E21.0 | Primary hyperparathyroidism | ccmpcm | not risk adjusted |
| E21.1 | Secondary hyperparathyroidism, not elsewhere classified | ccmpcm | not risk adjusted |
| E21.2 | Other hyperparathyroidism | ccmpcm | not risk adjusted |
| E21.3 | Hyperparathyroidism, unspecified | ccmpcm | not risk adjusted |
| E21.4 | Other specified disorders of parathyroid gland | ccmpcm | not risk adjusted |
| E21.5 | Disorder of parathyroid gland, unspecified | ccmpcm | not risk adjusted |
| E22.0 | Acromegaly and pituitary gigantism | ccmpcm | HCC 51 · Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders |
| E22.1 | Hyperprolactinemia | ccmpcm | not risk adjusted |
| E22.2 | Syndrome of inappropriate secretion of antidiuretic hormone | ccmpcm | not risk adjusted |
| E22.8 | Other hyperfunction of pituitary gland | ccmpcm | not risk adjusted |
| E22.9 | Hyperfunction of pituitary gland, unspecifiedlow specificity | ccmpcm | not risk adjusted |
| E23.0 | Hypopituitarism | ccmpcm | not risk adjusted |
| E23.1 | Drug-induced hypopituitarism | ccmpcm | not risk adjusted |
| E23.2 | Diabetes insipidus | ccmpcm | not risk adjusted |
| E23.3 | Hypothalamic dysfunction, not elsewhere classified | ccmpcm | not risk adjusted |
| E23.6 | Other disorders of pituitary gland | ccmpcm | not risk adjusted |
| E23.7 | Disorder of pituitary gland, unspecified | ccmpcm | not risk adjusted |
| E24.0 | Pituitary-dependent Cushing's disease | ccmpcm | HCC 51 · Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders |
| E24.1 | Nelson's syndrome | ccmpcm | not risk adjusted |
| E24.2 | Drug-induced Cushing's syndrome | ccmpcm | not risk adjusted |
| E24.3 | Ectopic ACTH syndrome | ccmpcm | not risk adjusted |
| E24.4 | Alcohol-induced pseudo-Cushing's syndrome | ccmpcm | not risk adjusted |
| E24.8 | Other Cushing's syndrome | ccmpcm | not risk adjusted |
| E24.9 | Cushing's syndrome, unspecifiedlow specificity | ccmpcm | not risk adjusted |
| E26.01 | Conn's syndrome | ccmpcm | not risk adjusted |
| E26.02 | Glucocorticoid-remediable aldosteronism | ccmpcm | not risk adjusted |
| E26.09 | Other primary hyperaldosteronism | ccmpcm | not risk adjusted |
| E26.1 | Secondary hyperaldosteronism | ccmpcm | not risk adjusted |
| E26.81 | Bartter's syndrome | ccmpcm | not risk adjusted |
| E26.89 | Other hyperaldosteronism | ccmpcm | not risk adjusted |
| E26.9 | Hyperaldosteronism, unspecified | ccmpcm | not risk adjusted |
| E27.0 | Other adrenocortical overactivity | ccmpcm | not risk adjusted |
| E27.1 | Primary adrenocortical insufficiency | ccmpcm | HCC 51 · Addison's and Cushing's Diseases, Acromegaly, and Other Specified Endocrine Disorders |
| E27.2 | Addisonian crisis | ccmpcm | not risk adjusted |
| E27.3 | Drug-induced adrenocortical insufficiency | ccmpcm | not risk adjusted |
| E27.40 | Unspecified adrenocortical insufficiencylow specificity | ccmpcm | not risk adjusted |
| E27.49 | Other adrenocortical insufficiency | ccmpcm | not risk adjusted |
| E27.5 | Adrenomedullary hyperfunction | ccmpcm | not risk adjusted |
| E27.8 | Other specified disorders of adrenal gland | ccmpcm | not risk adjusted |
| E27.9 | Disorder of adrenal gland, unspecifiedlow specificity | ccmpcm | not risk adjusted |
| E83.00 | Disorder of copper metabolism, unspecified | ccmpcm | HCC 50 · Amyloidosis, Porphyria, and Other Specified Metabolic Disorders |
| E83.01 | Wilson's disease | ccmpcm | HCC 50 · Amyloidosis, Porphyria, and Other Specified Metabolic Disorders |
| E83.09 | Other disorders of copper metabolism | ccmpcm | HCC 50 · Amyloidosis, Porphyria, and Other Specified Metabolic Disorders |
| E83.10 | Disorder of iron metabolism, unspecifiedlow specificity | ccmpcm | not risk adjusted |
| E83.110 | Hereditary hemochromatosis | ccmpcm | not risk adjusted |
| E83.111 | Hemochromatosis due to repeated red blood cell transfusions | ccmpcm | not risk adjusted |
| E83.118 | Other hemochromatosis | ccmpcm | not risk adjusted |
| E83.119 | Hemochromatosis, unspecifiedlow specificity | ccmpcm | not risk adjusted |
| E83.19 | Other disorders of iron metabolism | ccmpcm | not risk adjusted |
| E83.2 | Disorders of zinc metabolism | ccmpcm | not risk adjusted |
| E83.30 | Disorder of phosphorus metabolism, unspecifiedlow specificity | ccmpcm | not risk adjusted |
| E83.31 | Familial hypophosphatemia | ccmpcm | HCC 50 · Amyloidosis, Porphyria, and Other Specified Metabolic Disorders |
| E83.32 | Hereditary vitamin D-dependent rickets (type 1) (type 2) | ccmpcm | not risk adjusted |
| E83.39 | Other disorders of phosphorus metabolism | ccmpcm | not risk adjusted |
| E83.40 | Disorders of magnesium metabolism, unspecifiedlow specificity | ccmpcm | not risk adjusted |
| E83.41 | Hypermagnesemia | ccmpcm | not risk adjusted |
| E83.42 | Hypomagnesemia | ccmpcm | not risk adjusted |
| E83.49 | Other disorders of magnesium metabolism | ccmpcm | not risk adjusted |
| E83.50 | Unspecified disorder of calcium metabolismlow specificity | ccmpcm | not risk adjusted |
| E83.51 | Hypocalcemia | ccmpcm | not risk adjusted |
| E83.52 | Hypercalcemia | ccmpcm | not risk adjusted |
| E83.59 | Other disorders of calcium metabolism | ccmpcm | not risk adjusted |
| E83.81 | Hungry bone syndrome | ccmpcm | not risk adjusted |
| E83.820 | Generalized arterial calcification of infancy with unspecified genetic causalitylow specificity | ccmpcm | not risk adjusted |
| E83.821 | ENPP1 deficiency causing generalized arterial calcification of infancy | ccmpcm | not risk adjusted |
| E83.822 | ENPP1 deficiency causing autosomal recessive hypophosphatemic rickets type 2 | ccmpcm | not risk adjusted |
| E83.823 | ABCC6 deficiency causing generalized arterial calcification of infancy | ccmpcm | not risk adjusted |
| E83.824 | ABCC6 deficiency causing pseudoxanthoma elasticum | ccmpcm | not risk adjusted |
| E83.825 | CD73 deficiency causing arterial calcification | ccmpcm | not risk adjusted |
| E83.89 | Other disorders of mineral metabolism | ccmpcm | not risk adjusted |
| E83.9 | Disorder of mineral metabolism, unspecifiedlow specificity | ccmpcm | not risk adjusted |
| E86.0 | Dehydration | ccmpcm | not risk adjusted |
| E86.1 | Hypovolemia | ccmpcm | not risk adjusted |
| E86.9 | Volume depletion, unspecified | ccmpcm | not risk adjusted |
| E87.0 | Hyperosmolality and hypernatremia | ccmpcm | not risk adjusted |
| E87.1 | Hypo-osmolality and hyponatremia | ccmpcm | not risk adjusted |
| E87.20 | Acidosis, unspecified | ccmpcm | not risk adjusted |
| E87.21 | Acute metabolic acidosis | ccmpcm | not risk adjusted |
| E87.22 | Chronic metabolic acidosis | ccmpcm | not risk adjusted |
| E87.29 | Other acidosis | ccmpcm | not risk adjusted |
| E87.3 | Alkalosis | ccmpcm | not risk adjusted |
| E87.4 | Mixed disorder of acid-base balance | ccmpcm | not risk adjusted |
| E87.5 | Hyperkalemia | ccmpcm | not risk adjusted |
| E87.6 | Hypokalemia | ccmpcm | not risk adjusted |
| E87.70 | Fluid overload, unspecified | ccmpcm | not risk adjusted |
| E87.71 | Transfusion associated circulatory overload | ccmpcm | not risk adjusted |
| E87.79 | Other fluid overload | ccmpcm | not risk adjusted |
| E87.8 | Other disorders of electrolyte and fluid balance, not elsewhere classified | ccmpcm | not risk adjusted |
| E88.01 | Alpha-1-antitrypsin deficiency | ccmpcm | HCC 50 · Amyloidosis, Porphyria, and Other Specified Metabolic Disorders |
| E88.02 | Plasminogen deficiency | ccmpcm | not risk adjusted |
| E88.09 | Other disorders of plasma-protein metabolism, not elsewhere classified | ccmpcm | not risk adjusted |
| E88.10 | Lipodystrophy, unspecifiedlow specificity | ccmpcm | not risk adjusted |
| E88.11 | Partial lipodystrophy | ccmpcm | not risk adjusted |
| E88.12 | Generalized lipodystrophy | ccmpcm | not risk adjusted |
| E88.13 | Localized lipodystrophy | ccmpcm | not risk adjusted |
| E88.14 | HIV-associated lipodystrophy | ccmpcm | not risk adjusted |
| E88.19 | Other lipodystrophy, not elsewhere classified | ccmpcm | not risk adjusted |
| E88.2 | Lipomatosis, not elsewhere classified | ccmpcm | not risk adjusted |
| E88.3 | Tumor lysis syndrome | ccmpcm | not risk adjusted |
| E88.40 | Mitochondrial metabolism disorder, unspecifiedlow specificity | ccmpcm | not risk adjusted |
| E88.41 | MELAS syndrome | ccmpcm | not risk adjusted |
| E88.42 | MERRF syndrome | ccmpcm | not risk adjusted |
| E88.43 | Disorders of mitochondrial tRNA synthetases | ccmpcm | not risk adjusted |
| E88.49 | Other mitochondrial metabolism disorders | ccmpcm | not risk adjusted |
| E88.810 | Metabolic syndrome | ccmpcm | not risk adjusted |
| E88.811 | Insulin resistance syndrome, Type A | ccmpcm | not risk adjusted |
| E88.818 | Other insulin resistance | ccmpcm | not risk adjusted |
| E88.819 | Insulin resistance, unspecifiedlow specificity | ccmpcm | not risk adjusted |
| E88.82 | Obesity due to disruption of MC4R pathway | ccmpcm | not risk adjusted |
| E88.89 | Other specified metabolic disorders | ccmpcm | HCC 50 · Amyloidosis, Porphyria, and Other Specified Metabolic Disorders |
| E88.9 | Metabolic disorder, unspecifiedlow specificity | ccmpcm | not risk adjusted |
| E88.A | Wasting disease (syndrome) due to underlying condition | ccmpcm | not risk adjusted |
Cystic fibrosis and metabolic developmental disorders
E84, E70, E71, E72, E74, E75, E76, E77, E79, E80183 codes in familyrpmccmpcmrtmLung function and oxygenation for cystic fibrosis, with weight as a nutritional marker.
Cystic fibrosis and metabolic developmental disorders
E84, E70, E71, E72, E74, E75, E76, E77, E79, E80183 codes in familyrpmccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Cystic Fibrosis and Other Metabolic Developmental Disorders · Devices: Spirometer or peak flow meter, Pulse oximeter, Connected weight scale
This family runs to 183 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within E84, E70, E71, E72, E74, E75, E76, E77, E79, E80.
Neurologic and cognitive
Polyneuropathy and nerve disorders
G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65107 codes in familyccmpcmrtmPain and function scores, most often alongside diabetes management.
Polyneuropathy and nerve disorders
G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65107 codes in familyccmpcmrtmAdded by CCN Health · Devices: Patient-reported outcome app (RTM)
This family runs to 107 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65.
Other chronic and potentially disabling
Diabetic retinopathy and diabetic eye disease
E08.3, E09.3, E10.3, E11.3, E13.3, H35.0, H36319 codes in familyccmpcmGlycemic and blood pressure control are the modifiable drivers. Screening attendance is the care-coordination target.
Diabetic retinopathy and diabetic eye disease
E08.3, E09.3, E10.3, E11.3, E13.3, H35.0, H36319 codes in familyccmpcmCMS chronic condition · CCW category: Diabetes · Devices: Blood glucose meter, Continuous glucose monitor, Blood pressure cuff
This family runs to 319 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within E08.3, E09.3, E10.3, E11.3, E13.3, H35.0, H36.
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Clinical Context
Why endocrinology practices benefit from PCM.
Endocrinology practices can leverage PCM to improve patient outcomes through structured care management, generating $97–$220+ per patient per month in Medicare reimbursement while reducing avoidable hospitalizations.
Related Conditions
Condition monitoring guides.
FAQ
Common questions.
01
What ICD-10 codes qualify endocrinology patients for PCM?
CMS publishes no list of codes that qualify a patient for PCM: eligibility turns on the condition and on documented medical necessity. For endocrinology, 564 billable ICD-10-CM codes cover the conditions PCM manages, spanning 7 conditions including type 2 diabetes mellitus, type 1 diabetes mellitus, diabetes due to underlying condition, drugs or chemicals, other endocrine, nutritional and metabolic disorders, cystic fibrosis and metabolic developmental disorders, polyneuropathy and nerve disorders.
02
How does CCN Health support endocrinology practices with PCM?
CCN Health provides turnkey PCM services for endocrinology practices, including patient eligibility identification, enrollment documentation, device provisioning, clinical monitoring, and full Medicare billing support.
03
What is the revenue potential for PCM in endocrinology?
Reimbursement varies by locality and payer contract, so see the PCM billing guide for current figures. Endocrinology practices with a high prevalence of these conditions generally see the most benefit, particularly when PCM is combined with RPM and BHI for patients whose needs are distinct enough to document separately.
Sources & Compliance
Code set. Every code on this page is drawn from the official ICD-10-CM ICD-10-CM FY2026 (valid 2025-10-01 through 2026-09-30) released by CDC/NCHS, and only codes flagged valid for submission are listed. ICD-10-CM is published by the federal government and is in the public domain, so the descriptions here are the official long descriptors reproduced verbatim rather than summarized. The next code set, ICD-10-CM FY2027 (valid from 2026-10-01), is already reflected in the change flags.
Eligibility is not a code list. CMS does not publish a list of ICD-10 codes that qualify a patient for RPM, CCM, PCM, BHI, or RTM. Eligibility turns on the condition and on documented medical necessity. The programs shown against each condition are CCN Health’s clinical assessment of which programs that condition can support, not a statement of CMS approval.
Risk adjustment. HCC labels and category assignments come from the CMS-HCC V28 model for the 2026 payment year. Risk adjustment depends on the full encounter record, not on a single code, and the flags here are a prompt to check specificity rather than a payment guarantee.
CPT® notice. CPT is a registered trademark of the American Medical Association. CPT codes, descriptions, and other data only are copyright 2026 American Medical Association. All rights reserved. CPT is provided “as is” without warranty of any kind.
Sources. ICD-10-CM files, CDC/NCHS (cdc.gov); CMS Chronic Conditions Data Warehouse condition categories (ccwdata.org); CMS-HCC risk adjustment model software and ICD-10 mappings (cms.gov); AHRQ Clinical Classifications Software Refined (ahrq.gov).
Disclaimer. This page is informational and does not constitute billing, clinical, or legal advice. Diagnosis coding must reflect the documentation in the medical record. Verify all codes against the official CMS and CDC/NCHS publications and your contracted payer agreements before billing.