E08.41
BillableDiabetes mellitus due to underlying condition with diabetic mononeuropathy
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E08.41 an HCC code?
Yes. E08.41 maps to Diabetes with Chronic Complications under the CMS-HCC V28 risk adjustment model (and Diabetes with Chronic 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 E08.41
For E08.41to 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 E08.41 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E08.41 is the ICD-10-CM diagnosis code for diabetes mellitus due to underlying condition with diabetic mononeuropathy. Diabetes caused by another medical condition that damages a single nerve or nerve group, causing weakness or pain in specific areas of the body. E08.41 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, E08.41 maps to Diabetes with Chronic Complications (HCC 37) with a community, non-dual, aged base RAF weight of 0.245. Under the older V24 model, E08.41 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.
Document which specific nerve is affected to support medical necessity. Because E08.41 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 E08.41 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document which specific nerve is affected to support medical necessity
- •Distinguish from polyneuropathy which affects multiple nerves
Clinical Significance
Diabetes mellitus due to an underlying condition with diabetic mononeuropathy represents isolated single nerve dysfunction caused by microvascular ischemia from secondary diabetes. Common presentations include cranial nerve palsies (particularly CN III with pupil sparing), carpal tunnel syndrome, and other entrapment neuropathies. Unlike diabetic polyneuropathy, mononeuropathy often has an acute onset and may resolve spontaneously over weeks to months as collateral vascular supply develops.
Documentation Requirements
- ✓Document the underlying condition causing diabetes, the specific nerve affected, onset and duration of symptoms, neurological examination findings including the distribution of sensory or motor deficits, and nerve conduction study results if performed.
- ✓Record whether the mononeuropathy is acute or chronic and the functional impact.
Commonly Confused Codes
- •
- •
- •