E08.9 ICD-10-CM Code: Diabetes mellitus due to underlying condition without complications

Code

E08.9

Description

Diabetes mellitus due to underlying condition without complications

HCC (V28)

HCC 38 — Diabetes with No, Glycemic, or Unspecified Complications

RAF reference coefficient

0.166

Billable

Yes

Payment year

2026

HCC Category Mapping

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 E08.9 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for E08.9

What This Code Means

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, 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.

Commonly Confused Codes

• •E11.9 (Type 2 diabetes without complications) is frequently used instead when the provider fails to identify the underlying cause.
• •E13.9 (other specified diabetes without complications) may also be confused.
• •E08.65 (with hyperglycemia) should be used instead if the provider documents uncontrolled blood sugars even without organ complications.

Child Codes