What is ICD-10 code E09.10?

E09.10 is the ICD-10-CM diagnosis code for Drug or chemical induced diabetes mellitus with ketoacidosis without coma. Diabetes caused by medications or chemicals with ketoacidosis (dangerous acid buildup in blood) but the patient is conscious. E09.10 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E09.10 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. E09.10 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. E09.10 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does E09.10 map to under V28?

E09.10 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for E09.10?

E09.10 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for E09.10?

E09.10 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports E09.10?

Verify whether coma is present; if coma develops, use E09.11 instead Document the specific drug or chemical causing the diabetes for complete clinical picture E09.10 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

Can E09.10 be a primary diagnosis?

Usually yes, when it is the condition chiefly responsible for the encounter and the note supports it. The exception is in the code-first instruction: when poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4) is documented, that condition is sequenced first and E09.10 follows it. For risk adjustment the order does not matter; the V28 category is the same either way.

Which codes cannot be reported with E09.10?

The Excludes1 note that applies to E09.10 lists transitory endocrine and metabolic disorders specific to newborn (P70-P74); diabetes mellitus due to underlying condition (E08.-); gestational diabetes (O24.4-); neonatal diabetes mellitus (P70.2); and 5 more (see the notes on this page). An Excludes1 condition is not reported together with E09.10; report one or the other, unless the two conditions are unrelated, which the ICD-10-CM Official Guidelines (Section I.A.12.a) allow.

2026 ICD-10-CM E09.10: Drug or chemical induced diabetes

E09.10 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupE09.10

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Diabetes mellitus (E08-E13)

E09.10

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Drug or chemical induced diabetes mellitus with ketoacidosis without coma

Diabetes caused by medications or chemicals with ketoacidosis (dangerous acid buildup in blood) but the patient is conscious.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 019

HHS-HCC 019 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 17

Diabetes with Acute Complicat...

Code-level coefficient reference

RXHCC

Mapped

HCC 30

Diabetes with Complications

Code-level coefficient reference

Code Book Path

Official

E09Drug or chemical induced diabetes mellitus E09.1Drug or chemical induced diabetes mellitus with ketoacidosis E09.10Drug or chemical induced diabetes mellitus with ketoacidosis without coma

Inclusion Terms

Official

No inclusion terms are included in this display for E09.10. Check the code and parent instructions in the Code Book.

Excludes 2

Official

No Excludes 2 notes are included in this display for E09.10. Check the code and parent instructions in the Code Book.

Related Codes

Official

E09.11Drug or chemical induced diabetes mellitus with ketoacidosis with coma

Includes

Official

No Includes notes are included in this display for E09.10. Check the code and parent instructions in the Code Book.

Excludes 1

Official

transitory endocrine and metabolic disorders specific to newborn (P70-P74)Inherited from E00-E89, E09
diabetes mellitus due to underlying condition (E08.-)Inherited from E00-E89, E09
gestational diabetes (O24.4-)Inherited from E00-E89, E09
neonatal diabetes mellitus (P70.2)Inherited from E00-E89, E09
postpancreatectomy diabetes mellitus (E13.-)Inherited from E00-E89, E09
postprocedural diabetes mellitus (E13.-)Inherited from E00-E89, E09
secondary diabetes mellitus NEC (E13.-)Inherited from E00-E89, E09
type 1 diabetes mellitus (E10.-)Inherited from E00-E89, E09
type 2 diabetes mellitus (E11.-)Inherited from E00-E89, E09

Code First

Official

poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4)Inherited from E09

Use Additional

Official

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)Inherited from E09
code to identify control using:Inherited from E09
injectable non-insulin antidiabetic drugs (Z79.85)Inherited from E09
insulin (Z79.4)Inherited from E09
oral antidiabetic drugs (Z79.84)Inherited from E09
oral hypoglycemic drugs (Z79.84)Inherited from E09

Code Also

Official

No Code Also instructions are included in this display for E09.10. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

The specific drug or chemical causing the diabetes must be identified and coded separately.

Laboratory values including arterial blood gas, serum ketones, blood glucose, and anion gap should be documented.

The provider must confirm the patient has not lost consciousness to support the 'without coma' designation.

Intent of exposure (adverse effect vs.

MEAT Support

HCC Buddy guidance

The specific drug or chemical causing the diabetes must be identified and coded separately.

Laboratory values including arterial blood gas, serum ketones, blood glucose, and anion gap should be documented.

The provider must confirm the patient has not lost consciousness to support the 'without coma' designation.

Intent of exposure (adverse effect vs.

Audit Caution

HCC Buddy guidance

Ketoacidosis must be confirmed by laboratory evidence (pH, bicarbonate, ketones), not just suspected clinically.

Failing to code the causative agent and intent undermines the clinical picture.

The distinction between ketoacidosis and hyperosmolarity requires careful review of lab values, as treatment approaches differ significantly.

Common Mistakes

HCC Buddy guidance

E09.11 (with coma) is used when consciousness is lost.

E09.00 (hyperosmolarity without coma) involves a different mechanism without significant ketone production.

E10.10 (Type 1 with ketoacidosis without coma) should not be used when the diabetes is drug-induced rather than autoimmune.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is E09.10 an HCC code?

E09.10 is not in the CMS-HCC V28 or V24 community payment model. E09.10 has a separate mapping under the CMS-HCC ESRD model (HCC 17 (Diabetes with Acute Complications)) and the Part D RxHCC model (HCC 30 (Diabetes with Complications)); the applicable result needs member context. E09.10 also appears in the HHS-HCC commercial risk model (HCC 019 (HHS-HCC 019 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping.

Code: E09.10
Description: Drug or chemical induced diabetes mellitus with ketoacidosis without coma
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

ESRDHCC 17, Diabetes with Acute Complications

Not separately weighted

RxHCCHCC 30, Diabetes with Complications

Not separately weighted

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 E09.10 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for E09.10

For E09.10, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

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

Coder workflow notes

Get the V28 mapping + MEAT cheat sheet

One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

E09.10 is the ICD-10-CM diagnosis code for drug or chemical induced diabetes mellitus with ketoacidosis without coma. Diabetes caused by medications or chemicals with ketoacidosis (dangerous acid buildup in blood) but the patient is conscious. E09.10 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering diabetes mellitus (e08-e13).

E09.10 has no mapping under the CMS-HCC V28 or V24 community payment models. E09.10 has a separate mapping under the CMS-HCC ESRD model (HCC 17 (Diabetes with Acute Complications)) and the Part D RxHCC model (HCC 30 (Diabetes with Complications)); the applicable result needs member context. E09.10 also appears in the HHS-HCC commercial risk model (HCC 019 (HHS-HCC 019 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

Verify whether coma is present; if coma develops, use E09.11 instead.

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

Coding Tips

•Verify whether coma is present; if coma develops, use E09.11 instead
•Document the specific drug or chemical causing the diabetes for complete clinical picture

Clinical Significance

Drug or chemical induced diabetes mellitus with ketoacidosis without coma represents a dangerous metabolic emergency where a causative medication or chemical has triggered diabetes complicated by excessive ketone production and blood acidification. Diabetic ketoacidosis is characterized by hyperglycemia, metabolic acidosis, and ketonemia, requiring urgent treatment with intravenous fluids, insulin, and electrolyte management. The patient remains conscious but is in a critical metabolic state.

Documentation Requirements

✓The specific drug or chemical causing the diabetes must be identified and coded separately.
✓Laboratory values including arterial blood gas, serum ketones, blood glucose, and anion gap should be documented.
✓The provider must confirm the patient has not lost consciousness to support the 'without coma' designation.
✓Intent of exposure (adverse effect vs.
✓poisoning) must be specified.

Commonly Confused Codes

•E09.11 (with coma) is used when consciousness is lost.
•E09.00 (hyperosmolarity without coma) involves a different mechanism without significant ketone production.
•E10.10 (Type 1 with ketoacidosis without coma) should not be used when the diabetes is drug-induced rather than autoimmune.

Child Codes

E09.10Drug or chemical induced diabetes mellitus with ketoacidosis without coma

E09.11Drug or chemical induced diabetes mellitus with ketoacidosis with coma

Code Hierarchy

└E09Drug or chemical induced diabetes mellitus └E09.1Drug or chemical induced diabetes mellitus with ketoacidosis └E09.10Drug or chemical induced diabetes mellitus with ketoacidosis without coma

└E09.10Drug or chemical induced diabetes mellitus with ketoacidosis without coma

HCC Buddy Code Card

E09.10

Is E09.10 an HCC code?

HCC Category Mapping

MEAT review for E09.10

Get the V28 mapping + MEAT cheat sheet

What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Commonly Confused Codes

Child Codes

Code Hierarchy

Also searched as

Work E09.10 in HCC Buddy

E09.10 ICD-10-CM Code: Drug or chemical induced diabetes mellitus with ketoacidosis without coma

HCC Buddy Code Card

E09.10

Is E09.10 an HCC code?

HCC Category Mapping

MEAT review for E09.10

Get the V28 mapping + MEAT cheat sheet

What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Commonly Confused Codes

Child Codes

Code Hierarchy

Also searched as

Work E09.10 in HCC Buddy