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E08.610

Billable

Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is E08.610 an HCC code?

Yes. E08.610 maps to Diabetes with Chronic Complications under the CMS-HCC V28 risk adjustment model (and Diabetes with Chronic Complications under V24).

HCC Category Mapping

V28HCC 37Diabetes with Chronic Complications
0.245
V24HCC 18Diabetes with Chronic Complications
0.302
ESRDHCC 18Diabetes with Chronic Complications
0.000
RxHCCHCC 30Diabetes with Complications
0.000

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 E08.610

For E08.610 to 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 E08.610 during that encounter — not just copy-forwarded from a problem list.

What This Code Means

E08.610 is the ICD-10-CM diagnosis code for diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy. Diabetes caused by another medical condition that damages nerves and causes joint damage and arthritis, typically in the feet and ankles. E08.610 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, E08.610 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, E08.610 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.

Neuropathic arthropathy (Charcot joint) is a serious complication requiring careful documentation. Because E08.610 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 E08.610 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Neuropathic arthropathy (Charcot joint) is a serious complication requiring careful documentation
  • Specify which joints are affected to support the diagnosis

Clinical Significance

Diabetes mellitus due to an underlying condition with diabetic neuropathic arthropathy (Charcot joint) represents progressive destructive joint disease resulting from loss of protective sensation due to diabetic neuropathy. The midfoot (tarsometatarsal joints) is most commonly affected, progressing through acute inflammatory, fragmentation, and coalescence phases. If unrecognized, Charcot neuroarthropathy leads to severe foot deformity, instability, and ulceration with high amputation risk. Early recognition during the acute phase is critical for limb salvage.

Documentation Requirements

  • Document the underlying condition causing diabetes, the specific joint(s) affected, the Eichenholtz stage (acute/development, coalescence, or reconstruction), imaging findings (radiographs showing fragmentation, dislocation, or deformity), and offloading treatment (total contact cast, Charcot restraint orthotic walker).
  • Record the presence of concurrent neuropathy and any associated skin breakdown.

Commonly Confused Codes

Code Hierarchy

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