What is ICD-10 code E09.42?

E09.42 is the ICD-10-CM diagnosis code for Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy. Diabetes caused by medications or chemicals that damages multiple nerves throughout the body, typically causing numbness and weakness in the hands and feet. E09.42 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E09.42 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. E09.42 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. E09.42 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 E09.42 map to under V28?

E09.42 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for E09.42?

E09.42 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for E09.42?

E09.42 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports E09.42?

Document which nerves are affected and the distribution pattern (distal, symmetrical, etc.) Distinguish from mononeuropathy (E09.41) which affects only one nerve E09.42 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 E09.42: Drug or chemical induced diabetes

E09.42 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

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 lookupE09.42Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

E09.42

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

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

Diabetes caused by medications or chemicals that damages multiple nerves throughout the body, typically causing numbness and weakness in the hands and feet.

Buddy Insight

Drug or chemical induced diabetes mellitus with diabetic polyneuropathy is the most common neuropathic complication of drug-induced diabetes, involving symmetric damage to multiple peripheral nerves.

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

E09.42Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy

Inclusion Terms

Official

Drug or chemical induced diabetes mellitus with diabetic neuralgia

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E09.42 in this effective period.

Related Child Codes

Official

E09.40Drug or chemical induced diabetes mellitus with neurological complications with diabetic neuropathy, unspecified

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

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

ICD-10-CM does not list Includes notes for E09.42 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for E09.42 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E09.42 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for E09.42 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for E09.42 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

The causative drug or chemical must be documented and coded.

Clinical findings should describe the distribution pattern (distal, symmetric), affected modalities (sensory, motor, or both), and severity.

Monofilament testing results and vibration perception should be documented.

Nerve conduction studies, if performed, provide objective confirmation.

MEAT Support

HCC Buddy guidance

The causative drug or chemical must be documented and coded.

Clinical findings should describe the distribution pattern (distal, symmetric), affected modalities (sensory, motor, or both), and severity.

Monofilament testing results and vibration perception should be documented.

Nerve conduction studies, if performed, provide objective confirmation.

Audit Caution

HCC Buddy guidance

Do not code polyneuropathy without clinical documentation of multi-nerve involvement

numbness alone does not establish the diagnosis. Ensure the neuropathy is attributed to diabetes rather than to the causative drug's direct neurotoxic effects, which would require different coding. Foot examination findings should be documented to support preventive care planning.

Common Mistakes

HCC Buddy guidance

E09.41 (mononeuropathy) affects a single nerve rather than multiple nerves.

E09.43 (autonomic neuropathy) affects involuntary nervous system functions.

E09.40 (unspecified neuropathy) should not be used when polyneuropathy is documented.

G63 (polyneuropathy in diseases classified elsewhere) should not replace the combination code.

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 E09.42 an HCC code?

E09.42 is not in the CMS-HCC V28 or V24 community payment model. E09.42 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. E09.42 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: E09.42
Description: Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy
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 E09.42 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for E09.42

For E09.42 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 E09.42 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

E09.42 is the ICD-10-CM diagnosis code for drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy. Diabetes caused by medications or chemicals that damages multiple nerves throughout the body, typically causing numbness and weakness in the hands and feet. E09.42 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering diabetes mellitus (e08-e13).

E09.42 has no mapping under the CMS-HCC V28 or V24 community payment models. E09.42 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. E09.42 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.

Document which nerves are affected and the distribution pattern (distal, symmetrical, etc.).

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for E09.42 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document which nerves are affected and the distribution pattern (distal, symmetrical, etc.)
•Distinguish from mononeuropathy (E09.41) which affects only one nerve

Clinical Significance

Drug or chemical induced diabetes mellitus with diabetic polyneuropathy is the most common neuropathic complication of drug-induced diabetes, involving symmetric damage to multiple peripheral nerves. It typically presents with distal sensory loss in a 'stocking-glove' distribution, progressing from the feet proximally. Loss of protective sensation significantly increases risk for foot ulcers, infections, and amputations, making this a high-impact complication requiring proactive foot care and pain management.

Documentation Requirements

✓The causative drug or chemical must be documented and coded.
✓Clinical findings should describe the distribution pattern (distal, symmetric), affected modalities (sensory, motor, or both), and severity.
✓Monofilament testing results and vibration perception should be documented.
✓Nerve conduction studies, if performed, provide objective confirmation.

Commonly Confused Codes

•E09.41 (mononeuropathy) affects a single nerve rather than multiple nerves.
•E09.43 (autonomic neuropathy) affects involuntary nervous system functions.
•E09.40 (unspecified neuropathy) should not be used when polyneuropathy is documented.
•G63 (polyneuropathy in diseases classified elsewhere) should not replace the combination code.