E09.00 ICD-10-CM Code: Drug or chemical induced diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)

Code

E09.00

Description

Drug or chemical induced diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)

HCC (V28)

No CMS-HCC V28 mapping

RAF reference coefficient

—

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 E09.00 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for E09.00

What This Code Means

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for E09.00 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

• •Always identify and document the specific drug or chemical causing the diabetes, as this is required for accurate coding of drug-induced diabetes
• •Verify that the patient does NOT have NKHHC (nonketotic hyperglycemic-hyperosmolar coma); if they do, use code E09.01 instead

Clinical Significance

Drug or chemical induced diabetes mellitus with hyperosmolarity without coma represents a serious metabolic derangement where medications or toxic exposures have caused diabetes, and the patient has developed dangerously concentrated blood from extreme hyperglycemia. Hyperosmolarity indicates severe dehydration and glucose levels typically exceeding 600 mg/dL. Though the patient has not progressed to coma, this condition requires urgent inpatient management with aggressive fluid resuscitation and insulin therapy.

Documentation Requirements

• ✓The causative drug or chemical must be identified and documented with an additional external cause code from the Table of Drugs and Chemicals.
• ✓Serum osmolality, blood glucose levels, and mental status should be recorded.
• ✓Documentation must explicitly confirm the absence of nonketotic hyperglycemic-hyperosmolar coma to justify the 'without coma' distinction.

Commonly Confused Codes

• •E09.01 (with coma) should be used if the patient loses consciousness.
• •E09.10 (ketoacidosis without coma) is distinct because the pathophysiology involves acidosis rather than hyperosmolarity.
• •E11.00 (Type 2 with hyperosmolarity without coma) should not be used when the diabetes is drug-induced.

Child Codes