E09.621 ICD-10-CM Code: Drug or chemical induced diabetes mellitus with foot ulcer

Code

E09.621

Description

Drug or chemical induced diabetes mellitus with foot ulcer

HCC (V28)

No CMS-HCC V28 mapping

RAF reference coefficient

—

Billable

Yes

Payment year

2026

HCC Category Mapping

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 E09.621 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for E09.621

What This Code Means

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for E09.621 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

• •Always identify and document the specific drug or chemical that caused the diabetes, as this information supports medical necessity and helps with causality documentation
• •Ensure the foot ulcer is documented with its location and severity (stage), as this may require additional codes for the ulcer itself (L97 series) depending on your coding guidelines and payer requirements

Clinical Significance

Drug or chemical induced diabetes mellitus with foot ulcer is a serious complication combining impaired wound healing from diabetes with the biomechanical stresses on the foot. Diabetic foot ulcers are a leading cause of nontraumatic lower extremity amputation and represent a major source of morbidity, prolonged hospitalization, and healthcare expenditure. The presence of a foot ulcer in drug-induced diabetes signals the need for multidisciplinary care including vascular assessment, wound management, and offloading strategies.

Documentation Requirements

• ✓The causative drug or chemical must be identified.
• ✓The foot ulcer must be documented with its exact anatomical location, size, depth, and Wagner or University of Texas classification.
• ✓An additional code from L97 (non-pressure chronic ulcer of lower limb) specifying site and severity is required.
• ✓Vascular status and presence or absence of infection must be assessed and documented.

Commonly Confused Codes

• •E09.622 (other skin ulcer) applies to ulcers outside the foot.
• •E09.620 (dermatitis) is an inflammatory condition without ulceration.
• •E09.52 (peripheral angiopathy with gangrene) represents more advanced tissue death.
• •L97 codes specify ulcer location and severity and should be coded in addition to E09.621.

Child Codes