E09.22

Billable

Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease

HCC Category Mapping

V24HCC 18 — Diabetes with Chronic Complications

0.302

ESRDHCC 18 — Diabetes with Chronic Complications

0.000

RxHCCHCC 30 — Diabetes with Complications

0.000

What This Code Means

Diabetes caused by medications or chemicals that has damaged the kidneys, resulting in chronic kidney disease.

Coding Tips

•Code the stage of chronic kidney disease separately if documented (CKD stages 1-5)
•Verify the kidney damage is chronic rather than acute to ensure correct code selection

Clinical Significance

Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease indicates progressive, staged kidney damage resulting from diabetes caused by medication or chemical exposure. This code is more specific than E09.21 because it implies that the kidney disease has been formally staged (CKD stages 1-5). Chronic kidney disease in diabetic patients accelerates cardiovascular risk and may progress to end-stage renal disease requiring dialysis or transplant.

Documentation Requirements

✓The causative agent must be identified and coded.
✓Documentation must include the CKD stage (1-5), supported by estimated glomerular filtration rate or creatinine clearance values.
✓A separate code from the N18 series is required to specify the CKD stage.
✓The causal relationship between drug-induced diabetes and kidney damage must be documented.

Use Additional Code

code to identify stage of chronic kidney disease (N18.1-N18.6)

Commonly Confused Codes

E09.21 (diabetic nephropathy) is used when nephropathy is documented without formal CKD staging.E09.29 (other kidney complication) applies to kidney manifestations that are neither nephropathy nor CKD.N18.1-N18.6 must be coded additionally to specify CKD stage.E11.22 (Type 2 with CKD) is incorrect for drug-induced diabetes.

Code Hierarchy

└E09Drug or chemical induced diabetes mellitus └E09.2Drug or chemical induced diabetes mellitus with kidney complications └E09.22Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease

└E09.22Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease