E08.9
BillableDiabetes mellitus due to underlying condition without complications
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E08.9 an HCC code?
Yes. E08.9 maps to Diabetes without Complication under the CMS-HCC V28 risk adjustment model (and Diabetes without Complication 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 E08.9
For E08.9 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 E08.9 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E08.9 is the ICD-10-CM diagnosis code for diabetes mellitus due to underlying condition without complications. This code describes diabetes that has developed as a result of another medical condition (such as pancreatitis, cystic fibrosis, or hemochromatosis) and currently has no complications. The diabetes is secondary to the underlying disease rather than being primary Type 1 or Type 2 diabetes. E08.9 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, E08.9 maps to Diabetes without Complication (HCC 38) with a community, non-dual, aged base RAF weight of 0.450. Under the older V24 model, E08.9 mapped to the same category but with a base RAF weight of 0.105 — 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.
Always code the underlying condition first (such as pancreatitis or cystic fibrosis), then use E08.9 to indicate the secondary diabetes without complications. Because E08.9 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 E08.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always code the underlying condition first (such as pancreatitis or cystic fibrosis), then use E08.9 to indicate the secondary diabetes without complications
- •If complications develop (such as neuropathy, nephropathy, or retinopathy), use a more specific E08 code with the appropriate complication digit rather than E08.9
Clinical Significance
Diabetes mellitus due to an underlying condition without complications captures secondary diabetes that is currently well-managed without end-organ damage. The diabetes is not primary Type 1 or Type 2 but instead arises from diseases like pancreatitis, cystic fibrosis, Cushing syndrome, or hemochromatosis. Even without complications, this diagnosis requires ongoing monitoring because the underlying disease may worsen glycemic control over time.
Documentation Requirements
- ✓The underlying causative condition must be identified and coded first per ICD-10-CM sequencing rules.
- ✓Documentation should explicitly state that no diabetic complications (nephropathy, retinopathy, neuropathy, etc.) are present at the time of the encounter.
- ✓The clinical note should include current glucose management status and any monitoring plans.