What is ICD-10 code E08.36?

E08.36 is the ICD-10-CM diagnosis code for Diabetes mellitus due to underlying condition with diabetic cataract. Clouding of the eye lens caused by diabetes that stems from an underlying medical condition. It belongs to the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89). E08.36 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E08.36 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. E08.36 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. E08.36 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does E08.36 map to under V28?

E08.36 maps to CMS-HCC V28 HCC 37 (Diabetes with Chronic Complications). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM E08.36: Diabetes mellitus due

E08.36 maps to CMS-HCC V28 37. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupE08.36

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Diabetes mellitus (E08-E13)

E08.36

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Diabetes mellitus due to underlying condition with diabetic cataract

Clouding of the eye lens caused by diabetes that stems from an underlying medical condition.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 37

Diabetes with Chronic Complic...

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 020

HHS-HCC 020 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 18

Diabetes with Chronic Complic...

Code-level coefficient reference

RXHCC

Mapped

HCC 30

Diabetes with Complications

Code-level coefficient reference

Code Book Path

Official

E08Diabetes mellitus due to underlying condition E08.3Diabetes mellitus due to underlying condition with ophthalmic complications E08.36Diabetes mellitus due to underlying condition with diabetic cataract

Inclusion Terms

Official

No inclusion terms are included in this display for E08.36. Check the code and parent instructions in the Code Book.

Excludes 2

Official

No Excludes 2 notes are included in this display for E08.36. Check the code and parent instructions in the Code Book.

Related Codes

Official

E08.31Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy E08.32Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy E08.33Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy E08.34Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy E08.35Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy

Includes

Official

No Includes notes are included in this display for E08.36. Check the code and parent instructions in the Code Book.

Excludes 1

Official

transitory endocrine and metabolic disorders specific to newborn (P70-P74)Inherited from E00-E89, E08
drug or chemical induced diabetes mellitus (E09.-)Inherited from E00-E89, E08
gestational diabetes (O24.4-)Inherited from E00-E89, E08
neonatal diabetes mellitus (P70.2)Inherited from E00-E89, E08
postpancreatectomy diabetes mellitus (E13.-)Inherited from E00-E89, E08
postprocedural diabetes mellitus (E13.-)Inherited from E00-E89, E08
secondary diabetes mellitus NEC (E13.-)Inherited from E00-E89, E08
type 1 diabetes mellitus (E10.-)Inherited from E00-E89, E08
type 2 diabetes mellitus (E11.-)Inherited from E00-E89, E08

Code First

Official

the underlying condition, such as:Inherited from E08
congenital rubella (P35.0)Inherited from E08
Cushing's syndrome (E24.-)Inherited from E08
cystic fibrosis (E84.-)Inherited from E08
malignant neoplasm (C00-C96)Inherited from E08
malnutrition (E40-E46)Inherited from E08
pancreatitis and other diseases of the pancreas (K85-K86.-)Inherited from E08

Use Additional

Official

code to identify control using:Inherited from E08
injectable non-insulin antidiabetic drugs (Z79.85)Inherited from E08
insulin (Z79.4)Inherited from E08
oral antidiabetic drugs (Z79.84)Inherited from E08
oral hypoglycemic drugs (Z79.84)Inherited from E08

Code Also

Official

No Code Also instructions are included in this display for E08.36. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Document the underlying condition causing diabetes, the diabetic etiology of the cataract (not simply age-related cataract in a diabetic patient), the type and severity of cataract, visual acuity, and whether surgical intervention is planned.

Record concurrent diabetic retinopathy if present, as it affects surgical planning and visual prognosis.

MEAT Support

HCC Buddy guidance

Record concurrent diabetic retinopathy if present, as it affects surgical planning and visual prognosis.

Audit Caution

HCC Buddy guidance

Not all cataracts in diabetic patients are diabetic cataracts — the provider must document the causal relationship between diabetes and the cataract.

Age-related cataracts that coincidentally occur in diabetic patients should be coded with H25.x codes.

True diabetic cataracts tend to be posterior subcapsular and occur at younger ages.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is E08.36 an HCC code?

Yes. E08.36 (Diabetes mellitus due to underlying condition with diabetic cataract) maps to HCC 37, Diabetes with Chronic Complications under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.166. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: E08.36 is billable and maps to V28 HCC 37, Diabetes with Chronic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: E08.36
Description: Diabetes mellitus due to underlying condition with diabetic cataract
HCC (V28): HCC 37 — Diabetes with Chronic Complications
RAF reference coefficient: 0.166
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 37, Diabetes with Chronic Complications

0.166

ESRDHCC 18, Diabetes with Chronic Complications

Not separately weighted

RxHCCHCC 30, Diabetes with Complications

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work E08.36 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for E08.36

For E08.36, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

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

Coder workflow notes

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What This Code Means

E08.36 is the ICD-10-CM diagnosis code for diabetes mellitus due to underlying condition with diabetic cataract. Clouding of the eye lens caused by diabetes that stems from an underlying medical condition. E08.36 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, E08.36 maps to Diabetes with Chronic Complications (HCC 37) with a source-labeled community, non-dual, aged reference coefficient of 0.166. No V24 mapping is shown for E08.36; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Document the underlying condition causing the diabetes. For E08.36, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for E08.36 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document the underlying condition causing the diabetes
•Specify which eye(s) are affected if documented (right, left, or bilateral)

Clinical Significance

Diabetic cataract due to an underlying condition represents lens opacification directly caused by chronic hyperglycemia in secondary diabetes, typically presenting as posterior subcapsular cataracts that develop more rapidly than age-related cataracts. The osmotic stress from sorbitol accumulation in the lens and glycosylation of lens proteins accelerate cataract formation. These patients often require earlier surgical intervention and may have more complex postoperative courses due to concurrent diabetic retinopathy.

Documentation Requirements

✓Document the underlying condition causing diabetes, the diabetic etiology of the cataract (not simply age-related cataract in a diabetic patient), the type and severity of cataract, visual acuity, and whether surgical intervention is planned.
✓Record concurrent diabetic retinopathy if present, as it affects surgical planning and visual prognosis.