What is ICD-10 code E09.41?

E09.41 is the ICD-10-CM diagnosis code for Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy. Diabetes caused by medications or chemicals that damages a single nerve, causing weakness or numbness in one area of the body. E09.41 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E09.41 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. E09.41 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. E09.41 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 E09.41 map to under V28?

E09.41 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for E09.41?

E09.41 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for E09.41?

E09.41 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports E09.41?

Identify the specific drug or chemical causing the diabetes and document it in the medical record Confirm the mononeuropathy affects only one nerve; if multiple nerves are involved, use E09.42 instead E09.41 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.

2026 ICD-10-CM E09.41: Drug or chemical induced diabetes

E09.41 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

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Code lookupE09.41

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

E09.41

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

Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy

Diabetes caused by medications or chemicals that damages a single nerve, causing weakness or numbness in one area of the body.

Buddy Insight

Drug or chemical induced diabetes mellitus with diabetic mononeuropathy represents damage to a single peripheral nerve or nerve group caused by drug-induced diabetes.

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 020

HHS-HCC 020 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 18

Diabetes with Chronic Complic...

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 E09.4Drug or chemical induced diabetes mellitus with neurological complications E09.41Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy

Inclusion Terms

Official

No inclusion terms are included in this display for E09.41. Check the code and parent instructions in the Code Book.

Excludes 2

Official

No Excludes 2 notes are included in this display for E09.41. Check the code and parent instructions in the Code Book.

Related Codes

Official

E09.40Drug or chemical induced diabetes mellitus with neurological complications with diabetic neuropathy, unspecified E09.42Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy E09.43Drug or chemical induced diabetes mellitus with neurological complications with diabetic autonomic (poly)neuropathy E09.44Drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy E09.49Drug or chemical induced diabetes mellitus with neurological complications with other diabetic neurological complication

Includes

Official

No Includes notes are included in this display for E09.41. 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 E09.41. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

The causative drug or chemical must be identified and coded.

The specific nerve affected should be documented (e.g., median, ulnar, peroneal, or cranial nerve).

Clinical findings including motor and sensory deficits in the affected nerve distribution must be described.

Electrodiagnostic studies (nerve conduction/EMG) confirming the diagnosis should be referenced when available.

MEAT Support

HCC Buddy guidance

The causative drug or chemical must be identified and coded.

The specific nerve affected should be documented (e.g., median, ulnar, peroneal, or cranial nerve).

Clinical findings including motor and sensory deficits in the affected nerve distribution must be described.

Electrodiagnostic studies (nerve conduction/EMG) confirming the diagnosis should be referenced when available.

Audit Caution

HCC Buddy guidance

Distinguishing mononeuropathy from early polyneuropathy requires careful neurological documentation. Carpal tunnel syndrome in a diabetic patient is not automatically diabetic mononeuropathy

the causal relationship must be established. The causative drug must be identified to justify the E09 category.

Common Mistakes

HCC Buddy guidance

E09.42 (polyneuropathy) involves multiple nerves diffusely rather than a single nerve.

E09.40 (unspecified neuropathy) is less specific.

E09.44 (amyotrophy) involves proximal muscle wasting.

G56-G58 series (mononeuropathy codes) should not replace this combination code but may be used additionally for site specification.

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 E09.41 an HCC code?

E09.41 is not in the CMS-HCC V28 or V24 community payment model. E09.41 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. E09.41 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: E09.41
Description: Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy
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 E09.41 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for E09.41

For E09.41, 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

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What This Code Means

E09.41 is the ICD-10-CM diagnosis code for drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy. Diabetes caused by medications or chemicals that damages a single nerve, causing weakness or numbness in one area of the body. E09.41 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering diabetes mellitus (e08-e13).

E09.41 has no mapping under the CMS-HCC V28 or V24 community payment models. E09.41 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. E09.41 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.

Identify the specific drug or chemical causing the diabetes and document it in the medical record.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for E09.41 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Identify the specific drug or chemical causing the diabetes and document it in the medical record
•Confirm the mononeuropathy affects only one nerve; if multiple nerves are involved, use E09.42 instead

Clinical Significance

Drug or chemical induced diabetes mellitus with diabetic mononeuropathy represents damage to a single peripheral nerve or nerve group caused by drug-induced diabetes. Unlike the more common diffuse polyneuropathy, mononeuropathy causes focal deficits such as wrist drop, foot drop, or cranial nerve palsies (e.g., third nerve palsy causing double vision). The acute onset and focal nature often prompt urgent neurological evaluation to rule out other causes.

Documentation Requirements

✓The causative drug or chemical must be identified and coded.
✓The specific nerve affected should be documented (e.g., median, ulnar, peroneal, or cranial nerve).
✓Clinical findings including motor and sensory deficits in the affected nerve distribution must be described.
✓Electrodiagnostic studies (nerve conduction/EMG) confirming the diagnosis should be referenced when available.

Commonly Confused Codes

•E09.42 (polyneuropathy) involves multiple nerves diffusely rather than a single nerve.
•E09.40 (unspecified neuropathy) is less specific.
•E09.44 (amyotrophy) involves proximal muscle wasting.
•G56-G58 series (mononeuropathy codes) should not replace this combination code but may be used additionally for site specification.