E11.22 Maps to HCC 37 in V28. You Still Need the N18 Stage.
E11.22 maps to V28 HCC 37 (CNA 0.166). It does not capture CKD stage. Desk table for the Use Additional N18.1-N18.6 pair: the CKD payment HCC comes from N18, not E11.22. N18.9 is not mapped.
By the HCC Buddy Coding Team
Updated: August 25, 2026
E11.22 maps to HCC 37. It does not capture CKD stage. The leftover search lands on the E11.22 card. That card does not pay a CKD HCC. The N18 stage code does.
Open the live E11.22, N18.32, N18.4, and N18.5 cards before you invent a CKD map on the diabetes row. This page is the desk table for that leftover. It is not a rewrite of the E11.52 leftover. It is not the I70.209 leftover. It is not a G0685 or V44 story.
*Current as of August 25, 2026. V28 mapping and CNA factors come from the live code pages named below and the 2026 Final ICD-10-CM Mappings. Payment year 2026 is 100% V28. Look the exact codes up. Do not code from this recap. Do not invent an N18.1 or N18.2 map.*
Quick answer
Yes. E11.22 is HCC 37, CNA 0.166. It does not capture CKD stage. Use Additional is N18.1-N18.6. The CKD payment HCC comes from N18, not E11.22.
| Code | What the row is naming | V28 payment HCC | CNA |
|---|---|---|---|
| E11.22 | Type 2 DM with diabetic CKD | HCC 37 | 0.166 |
| N18.32 | CKD, stage 3b | HCC 328 | 0.127 |
| N18.4 | CKD, stage 4 (severe) | HCC 327. N18 Code First diabetic CKD | 0.514 |
| N18.5 | CKD, stage 5 | HCC 326. N18 Code First diabetic CKD. Excludes1 N18.6 | 0.815 |
| N18.6 | ESRD | HCC 326 | 0.815 |
| N18.9 | CKD, unspecified | not mapped | none |
N18.30 and N18.31 map to HCC 329, CNA 0.127. The PY2026 V28 map file has no N18.1 or N18.2 rows. Do not invent those maps. If the record supports stage 1 or 2, assign N18.1 or N18.2. That is complete ICD-10-CM coding. It is not a payment HCC.
Use Additional is the stage
On the FY2026 Apr tabular:
Do not stop at 37. Do not expect E11.22 to pay a CKD HCC.
36, 37, and 38 share 0.166
HCC 36, HCC 37, and HCC 38 share CNA 0.166. E11.22 versus E11.9 does not change the diabetes dollar. E11.22 names diabetic CKD so a paired N18 can carry a separate CKD HCC.
Do not recode E11.9 to E11.22 to pick up a heavier diabetes weight. That heavier diabetes weight is not in the PY2026 CNA column.
Do not code E11.21 with E11.22
E11.21 is Type 2 DM with diabetic nephropathy. It maps to HCC 37. E11.22 is the diabetic CKD combination. Do not code E11.21 and E11.22 together.
Do not pair E11.22 with N18.9 when the record supports a stage.
Do not stage from a single eGFR
An eGFR is a lab. It does not select N18.31 or N18.32 by itself. Code the stage the provider documented. Query if the stage is missing. Keep N18.9 when the stage was never documented. N18.9 is not mapped.
MEAT both this year
Mapped codes still need monitoring, evaluation, assessment, or treatment this visit. MEAT E11.22 and the N18 stage this year. A problem-list row from last year is not enough. See MEAT criteria and problem lists do not validate HCCs. MEAT is the training mnemonic. The authorities are the Official Guidelines and the record from the date of service.
Common misses
1. Stopping at 37. E11.22 is HCC 37. The CKD payment HCC is on N18.
2. Expecting E11.22 to pay a CKD HCC. Use Additional is N18.1-N18.6. The stage code carries the CKD HCC.
3. Pairing E11.22 with N18.9. N18.9 is not mapped. Use Additional does not name N18.9.
4. Coding E11.21 and E11.22 together. E11.22 is the diabetic CKD combination.
5. Staging from a lab only. Do not pick N18.31 or N18.32 from a single eGFR.
6. Inventing an N18.1 or N18.2 map. The PY2026 V28 map file has no N18.1 or N18.2 rows.
Two-minute check
1. Confirm the provider assessed diabetic CKD this visit.
2. Assign E11.22. Look that exact code up on HCC Buddy or in the encoder. Expect HCC 37, CNA 0.166.
3. Assign the N18 stage the record supports (N18.1-N18.6). Do not invent N18.1 or N18.2 maps. Do not use N18.9 when a stage is documented.
4. Sequence E11.22 first. N18 Code First names diabetic CKD.
5. Confirm MEAT on both codes this visit. Do not stage from a single eGFR.
Related
Disclaimer
This article is for professional and educational use only. It is not coding, billing, legal, or medical advice. Verify every code, HCC map, and guideline section against current official CMS and ICD-10-CM guidance and your payer's policy before you assign it. Reading it creates no provider, patient, or advisory relationship.
By the HCC Buddy Coding Team. V28 mappings and CNA factors from the cited live code pages (CMS-HCC V28 PY2026 model software and ICD-10-CM mapping file). Not medical advice. Not a CMS-HCC model change beyond V28. Not a rewrite of the E11.52 leftover. Not an I70.209 leftover. Not a G0685 or V44 story.
Sources
E11.22 (V28 HCC 37 CNA 0.166; Use Additional N18.1-N18.6)
N18.32 (V28 HCC 328 CNA 0.127)
N18.4 (V28 HCC 327 CNA 0.514; N18 Code First diabetic CKD E08.22-E13.22 and hypertensive I12.- / I13.-)
N18.5 (V28 HCC 326 CNA 0.815; Excludes1 N18.6)
N18.6 (V28 HCC 326 CNA 0.815)
N18.9 (not mapped)
Related Tools
E11.22 card
V28 HCC 37, CNA 0.166. Confirm the live card. It does not capture CKD stage.
N18.32 card
CKD stage 3b. V28 HCC 328, CNA 0.127.
N18.4 card
CKD stage 4. V28 HCC 327, CNA 0.514. N18 Code First names diabetic CKD.
N18.5 card
CKD stage 5. V28 HCC 326, CNA 0.815. Excludes1 N18.6.
CKD HCC guide
N18.9 has no V28 HCC. Stage maps live there. This post is the E11.22 leftover.
Combination codes
Combination-code mechanics. This post is the E11.22 / N18 stage leftover.
Diabetes HCC guide
E11.9 still maps to HCC 38. HCC 36, 37, and 38 share 0.166. This post is the E11.22 leftover.
Encoder
Look up the exact E11.22 or N18 stage the record supports.
HCC Buddy Coding Team
Editorial
Every HCC Buddy article is checked against the current CMS-HCC model and the active FY ICD-10-CM tabular release before it publishes.
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