E09.610 ICD-10-CM Code: Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Diabetes mellitus (E08-E13)
E09.610
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDrug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy
Diabetes caused by medications or chemicals that damages nerves and causes joint damage, particularly in the feet, leading to joint destruction.
Buddy Insight
Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy, also known as Charcot joint, represents severe joint destruction resulting from loss of protective pain sensation due to diabetic neuropathy.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
MappedHCC 18
RAF 0.302
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 18
RAF 0.0
RXHCC
MappedHCC 30
RAF 0.0
Code Trumping
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Code Book Path
Inclusion Terms
Official- Drug or chemical induced diabetes mellitus with Charcôt's joints
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E09.610 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for E09.610 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for E09.610 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E09.610 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for E09.610 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for E09.610 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 E09.610 an HCC code?
Yes. E09.610 maps to Diabetes with Chronic Complications under the V24 model but is not retained in V28.
HCC Category Mapping
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 E09.610
For E09.610to 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 E09.610 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
E09.610 is the ICD-10-CM diagnosis code for drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy. Diabetes caused by medications or chemicals that damages nerves and causes joint damage, particularly in the feet, leading to joint destruction. E09.610 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, E09.610 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 which joints are affected and the degree of destruction. Because E09.610 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 E09.610 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document which joints are affected and the degree of destruction
- •Neuropathic arthropathy (Charcot joint) results from nerve damage reducing pain sensation, allowing joint damage
Clinical Significance
Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy, also known as Charcot joint, represents severe joint destruction resulting from loss of protective pain sensation due to diabetic neuropathy. The condition most commonly affects the foot and ankle, causing progressive bone fragmentation, joint subluxation, and architectural collapse. Early recognition is critical because weight-bearing on an insensate, structurally compromised joint leads to deformity that significantly increases amputation risk.
Documentation Requirements
- ✓The causative drug or chemical must be documented.
- ✓The affected joint(s) must be identified with imaging findings (X-ray or MRI) showing characteristic bone and joint changes.
- ✓Documentation should link the neuropathic arthropathy to underlying diabetic neuropathy.
- ✓The stage of Charcot process (acute inflammatory vs.
- ✓chronic reconstructive) should be noted when possible.
Commonly Confused Codes
- •E09.618 (other diabetic arthropathy) is for joint conditions that are not neuropathic in nature.
- •E09.42 (polyneuropathy) captures the underlying neuropathy but not the joint destruction.
- •M14.6 (neuropathic arthropathy) should not replace this combination code.
- •E09.621 (foot ulcer) may coexist with Charcot foot and should be coded separately.