E09.22 ICD-10-CM Code: Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease
E09.22 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · free HCC coding tools
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Diabetes mellitus (E08-E13)
E09.22
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDrug or chemical induced diabetes mellitus with diabetic chronic kidney disease
Diabetes caused by medications or chemicals that has damaged the kidneys, resulting in chronic kidney disease.
Buddy Insight
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.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
MappedHCC 18
RAF 0.302
ACA/HHS
MappedHCC 20
Varies by metal level
ESRD/PACE
MappedHCC 18
RAF 0.084
RXHCC
MappedHCC 30
RAF 0.495
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for E09.22 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E09.22 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for E09.22 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for E09.22 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E09.22 in this effective period.
Use Additional
Official- code to identify stage of chronic kidney disease (N18.1-N18.6)
Code Also
OfficialICD-10-CM does not list Code Also instructions for E09.22 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 E09.22 an HCC code?
Yes. E09.22 maps to Diabetes with Chronic Complications under the V24 model but is not retained in V28.
- Code
- E09.22
- Description
- Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so 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 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.
Work E09.22 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for E09.22
For E09.22 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 E09.22 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
E09.22 is the ICD-10-CM diagnosis code for drug or chemical induced diabetes mellitus with diabetic chronic kidney disease. Diabetes caused by medications or chemicals that has damaged the kidneys, resulting in chronic kidney disease. E09.22 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 older CMS-HCC V24 model, E09.22 maps to Diabetes with Chronic Complications (HCC 18) with a community, non-dual, aged base RAF weight of 0.302. 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.
Code the stage of chronic kidney disease separately if documented (CKD stages 1-5). Because E09.22 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 E09.22 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
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.
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.