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E09.29 ICD-10-CM Code: Drug or chemical induced diabetes mellitus with other diabetic kidney complication

E09.29 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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

E09.29

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

Drug or chemical induced diabetes mellitus with other diabetic kidney complication

Diabetes caused by medications or chemicals with kidney complications other than chronic kidney disease.

Buddy the Bee presenting code insight

Buddy Insight

Drug or chemical induced diabetes mellitus with other diabetic kidney complication captures renal manifestations of drug-induced diabetes that do not meet the criteria for nephropathy or chronic kidney disease.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 020

Code-level coefficient reference

ESRD/PACE

HCC 18

Code-level coefficient reference

RXHCC

HCC 30

Code-level coefficient reference

Code Book Path

Official
E09Drug or chemical induced diabetes mellitus
E09.2Drug or chemical induced diabetes mellitus with kidney complications
E09.29Drug or chemical induced diabetes mellitus with other diabetic kidney complication

Inclusion Terms

Official
  • Drug or chemical induced diabetes mellitus with renal tubular degeneration

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E09.29 in this effective period.

Related Child Codes

Official
E09.21Drug or chemical induced diabetes mellitus with diabetic nephropathy
E09.22Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease

Includes

Official

ICD-10-CM does not list Includes notes for E09.29 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for E09.29 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E09.29 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for E09.29 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for E09.29 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
The causative drug or chemical must be documented and coded separately.
The specific kidney complication must be described in clinical detail, and documentation should explain why it does not fit the nephropathy (E09.21) or CKD (E09.22) categories.
Supporting laboratory and imaging findings should be included.

MEAT Support

HCC Buddy guidance
The causative drug or chemical must be documented and coded separately.
The specific kidney complication must be described in clinical detail, and documentation should explain why it does not fit the nephropathy (E09.21) or CKD (E09.22) categories.
Supporting laboratory and imaging findings should be included.

Audit Caution

HCC Buddy guidance
This code should not be used as a default when documentation is unclear about the type of kidney involvement.
Query the provider to determine if nephropathy or CKD staging is present before selecting this residual code.
Ensure the kidney complication is causally linked to the drug-induced diabetes.

Common Mistakes

HCC Buddy guidance
E09.21 (nephropathy) and E09.22 (CKD) are more specific and should be used when those conditions are present.
E09.29 is a residual category that should only be used when the kidney complication is documented but not classifiable as nephropathy or CKD.
N28.9 (disorder of kidney, unspecified) may be used erroneously instead.

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 E09.29 an HCC code?

E09.29 is not in the CMS-HCC V28 or V24 community payment model. E09.29 has a separate mapping under the CMS-HCC ESRD model (HCC 18 (Diabetes with Chronic Complications)) and the Part D RxHCC model (HCC 30 (Diabetes with Complications)); the applicable result needs member context. E09.29 also appears in the HHS-HCC commercial risk model (HCC 020 (HHS-HCC 020 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping.

Code
E09.29
Description
Drug or chemical induced diabetes mellitus with other diabetic kidney complication
HCC (V28)
No CMS-HCC V28 mapping
RAF reference coefficient
Billable
Yes
Payment year
2026

HCC Category Mapping

ESRDHCC 18, Diabetes with Chronic 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 E09.29 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for E09.29

For E09.29 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 E09.29 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

E09.29 is the ICD-10-CM diagnosis code for drug or chemical induced diabetes mellitus with other diabetic kidney complication. Diabetes caused by medications or chemicals with kidney complications other than chronic kidney disease. E09.29 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering diabetes mellitus (e08-e13).

E09.29 has no mapping under the CMS-HCC V28 or V24 community payment models. E09.29 has a separate mapping under the CMS-HCC ESRD model (HCC 18 (Diabetes with Chronic Complications)) and the Part D RxHCC model (HCC 30 (Diabetes with Complications)); the applicable result needs member context. E09.29 also appears in the HHS-HCC commercial risk model (HCC 020 (HHS-HCC 020 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.

Use this code when kidney involvement is present but does not meet criteria for chronic kidney disease.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for E09.29 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code when kidney involvement is present but does not meet criteria for chronic kidney disease
  • Document the specific kidney complication (such as diabetic nephropathy without CKD staging)

Clinical Significance

Drug or chemical induced diabetes mellitus with other diabetic kidney complication captures renal manifestations of drug-induced diabetes that do not meet the criteria for nephropathy or chronic kidney disease. This may include conditions such as renal tubular acidosis, papillary necrosis, or acute kidney injury related to diabetic processes. These atypical kidney complications may require specialized nephrology evaluation.

Documentation Requirements

  • The causative drug or chemical must be documented and coded separately.
  • The specific kidney complication must be described in clinical detail, and documentation should explain why it does not fit the nephropathy (E09.21) or CKD (E09.22) categories.
  • Supporting laboratory and imaging findings should be included.

Commonly Confused Codes

  • E09.21 (nephropathy) and E09.22 (CKD) are more specific and should be used when those conditions are present.
  • E09.29 is a residual category that should only be used when the kidney complication is documented but not classifiable as nephropathy or CKD.
  • N28.9 (disorder of kidney, unspecified) may be used erroneously instead.

Child Codes

Code Hierarchy

Work E09.29 in HCC Buddy

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