E08.10 ICD-10-CM Code: Diabetes mellitus due to underlying condition with ketoacidosis without coma
HCC Buddy Code Card
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Diabetes mellitus (E08-E13)
E08.10
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDiabetes mellitus due to underlying condition with ketoacidosis without coma
Dangerous acid buildup in the blood from diabetes caused by an underlying condition, without loss of consciousness.
Buddy Insight
Diabetes mellitus due to an underlying condition with ketoacidosis without coma represents an acute metabolic emergency in secondary diabetes characterized by hyperglycemia, metabolic acidosis, and ketonemia.
CMS-HCC V28
MappedHCC 36
RAF 0.390
CMS-HCC V24
MappedHCC 17
RAF 0.302
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 17
RAF 0.0
RXHCC
MappedHCC 30
RAF 0.0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for E08.10 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E08.10 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for E08.10 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for E08.10 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E08.10 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for E08.10 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for E08.10 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is E08.10 an HCC code?
Yes. E08.10 maps to Diabetes with Acute Complications under the CMS-HCC V28 risk adjustment model (and Diabetes with Acute Complications under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for E08.10
For E08.10to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed E08.10 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
E08.10 is the ICD-10-CM diagnosis code for diabetes mellitus due to underlying condition with ketoacidosis without coma. Dangerous acid buildup in the blood from diabetes caused by an underlying condition, without loss of consciousness. E08.10 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering diabetes mellitus (e08-e13).
Under the CMS-HCC V28 risk adjustment model, E08.10 maps to Diabetes with Acute Complications (HCC 36) with a community, non-dual, aged base RAF weight of 0.390. Under the older V24 model, E08.10 mapped to the same category but with a base RAF weight of 0.302, V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Identify and code the underlying condition that triggered the diabetes. Because E08.10 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E08.10 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Identify and code the underlying condition that triggered the diabetes
- •Confirm absence of coma; if coma is present, use E08.11 instead
Clinical Significance
Diabetes mellitus due to an underlying condition with ketoacidosis without coma represents an acute metabolic emergency in secondary diabetes characterized by hyperglycemia, metabolic acidosis, and ketonemia. The underlying conditions (pancreatitis, cystic fibrosis, post-pancreatectomy) often cause insulin deficiency severe enough to produce diabetic ketoacidosis, unlike typical type 2 diabetes. This requires immediate insulin therapy, fluid resuscitation, and electrolyte correction.
Documentation Requirements
- ✓Document the underlying condition causing diabetes, laboratory evidence of diabetic ketoacidosis (arterial pH, anion gap, serum bicarbonate, beta-hydroxybutyrate, serum glucose), absence of coma, and the precipitating event if identifiable.
- ✓Sequence the underlying condition code before this code.
- ✓Record insulin drip protocol and fluid/electrolyte management.
Commonly Confused Codes
- •E08.11: Same condition WITH coma: use when altered consciousness or coma accompanies the ketoacidosis
- •E08.00: Diabetes due to underlying condition with hyperosmolarity: different acute metabolic derangement
- •E10.10: Type 1 diabetes with ketoacidosis: use for autoimmune type 1 diabetes, not secondary diabetes