What is ICD-10 code E09.44?

E09.44 is the ICD-10-CM diagnosis code for Drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy. Diabetes caused by medications or chemicals that causes muscle weakness and wasting, typically affecting the thigh and hip muscles. E09.44 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E09.44 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. E09.44 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. E09.44 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.

What is the V28 vs V24 difference for E09.44?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. E09.44 was a payment HCC under V24 (Diabetes with Chronic Complications) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting E09.44?

Document the specific muscles affected and any imaging or EMG findings confirming muscle involvement Amyotrophy involves muscle degeneration, distinguishing it from other neuropathies Because E09.44 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

E09.44 ICD-10 Code: Drug or chemical induced

ICD-10-CM Code View

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Code lookupE09.44Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

E09.44

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

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

Diabetes caused by medications or chemicals that causes muscle weakness and wasting, typically affecting the thigh and hip muscles.

Buddy Insight

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Mapped

HCC 18

Diabetes with Chronic Complic...

RAF 0.302

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 18

Diabetes with Chronic Complic...

RAF 0.0

RXHCC

Mapped

HCC 30

Diabetes with Complications

RAF 0.0

Code Trumping

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Code Book Path

Official

E09Drug or chemical induced diabetes mellitus

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

E09.44Drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for E09.44 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E09.44 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

E09.42Drug 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

E09.49Drug or chemical induced diabetes mellitus with neurological complications with other diabetic neurological complication

Includes

Official

ICD-10-CM does not list Includes notes for E09.44 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for E09.44 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E09.44 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for E09.44 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for E09.44 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

The causative drug or chemical must be documented.

Clinical findings should describe the specific muscles affected, including detailed motor examination with strength grading.

EMG and nerve conduction study results confirming proximal denervation should be referenced.

MRI of the lumbosacral plexus may show enhancement in acute cases.

MEAT Support

HCC Buddy guidance

The causative drug or chemical must be documented.

Clinical findings should describe the specific muscles affected, including detailed motor examination with strength grading.

EMG and nerve conduction study results confirming proximal denervation should be referenced.

MRI of the lumbosacral plexus may show enhancement in acute cases.

Audit Caution

HCC Buddy guidance

Amyotrophy is often misdiagnosed as lumbar radiculopathy, peripheral vascular disease, or inflammatory myopathy.

The key distinguishing feature is the combination of severe pain with proximal weakness in a diabetic patient.

The drug-induced etiology must be established to justify the E09 category rather than E10 or E11.

Common Mistakes

HCC Buddy guidance

E09.42 (polyneuropathy) involves distal symmetric nerve damage rather than proximal muscle wasting.

E09.41 (mononeuropathy) affects a single nerve territory.

M62.50 (muscle wasting, unspecified) should not be used as an alternative to this specific combination code.

G73.0 (myasthenic syndromes in other diseases) represents a different pathophysiology.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is E09.44 an HCC code?

Yes. E09.44 maps to Diabetes with Chronic Complications under the V24 model but is not retained in V28.

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

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.

MEAT Criteria for E09.44

For E09.44to 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 E09.44 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

E09.44 is the ICD-10-CM diagnosis code for drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy. Diabetes caused by medications or chemicals that causes muscle weakness and wasting, typically affecting the thigh and hip muscles. E09.44 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, E09.44 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.

Document the specific muscles affected and any imaging or EMG findings confirming muscle involvement. Because E09.44 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 E09.44 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document the specific muscles affected and any imaging or EMG findings confirming muscle involvement
•Amyotrophy involves muscle degeneration, distinguishing it from other neuropathies

Clinical Significance

Drug or chemical induced diabetes mellitus with diabetic amyotrophy is a painful condition involving asymmetric proximal muscle weakness and wasting, typically affecting the thigh, hip, and pelvic girdle muscles. Also known as diabetic lumbosacral radiculoplexus neuropathy, it often presents acutely with severe pain followed by progressive weakness and weight loss. While it may partially resolve over months to years, residual weakness is common and significantly impacts mobility and function.

Documentation Requirements

✓The causative drug or chemical must be documented.
✓Clinical findings should describe the specific muscles affected, including detailed motor examination with strength grading.
✓EMG and nerve conduction study results confirming proximal denervation should be referenced.
✓MRI of the lumbosacral plexus may show enhancement in acute cases.
✓Weight loss and pain severity should be documented.

Commonly Confused Codes

•E09.42 (polyneuropathy) involves distal symmetric nerve damage rather than proximal muscle wasting.
•E09.41 (mononeuropathy) affects a single nerve territory.
•M62.50 (muscle wasting, unspecified) should not be used as an alternative to this specific combination code.
•G73.0 (myasthenic syndromes in other diseases) represents a different pathophysiology.