What is ICD-10 code E09.69?

E09.69 is the ICD-10-CM diagnosis code for Drug or chemical induced diabetes mellitus with other specified complication. Diabetes caused by medications or chemicals with other complications not specifically listed, such as complications affecting multiple body systems. E09.69 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E09.69 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. E09.69 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. E09.69 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 E09.69?

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. E09.69 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 E09.69?

Use this code only when the complication doesn't fit into more specific E09 subcategories Clearly document the nature of the complication in the medical record Because E09.69 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.

E09.69 ICD-10 Code: Drug or chemical induced

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 lookupE09.69Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

E09.69

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

Drug or chemical induced diabetes mellitus with other specified complication

Diabetes caused by medications or chemicals with other complications not specifically listed, such as complications affecting multiple body systems.

Buddy Insight

Drug or chemical induced diabetes mellitus with other specified complication captures diabetic complications that do not fit standard subcategories involving specific organ systems.

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

E09.6Drug or chemical induced diabetes mellitus with other specified complications

E09.69Drug or chemical induced diabetes mellitus with other specified complication

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for E09.69 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E09.69 in this effective period.

Related Child Codes

Official

E09.61Drug or chemical induced diabetes mellitus with diabetic arthropathy

E09.62Drug or chemical induced diabetes mellitus with skin complications

E09.63Drug or chemical induced diabetes mellitus with oral complications

E09.64Drug or chemical induced diabetes mellitus with hypoglycemia

E09.65Drug or chemical induced diabetes mellitus with hyperglycemia

Includes

Official

ICD-10-CM does not list Includes notes for E09.69 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for E09.69 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E09.69 in this effective period.

Use Additional

Official

code to identify complication

Code Also

Official

ICD-10-CM does not list Code Also instructions for E09.69 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

The causative drug or chemical must be identified.

The specific complication must be clearly described and differentiated from complications with dedicated codes (renal, ophthalmic, neurological, circulatory, skin, oral).

Documentation should explain why existing subcategories do not adequately capture the complication.

The causal relationship to drug-induced diabetes must be established.

MEAT Support

HCC Buddy guidance

The causative drug or chemical must be identified.

The specific complication must be clearly described and differentiated from complications with dedicated codes (renal, ophthalmic, neurological, circulatory, skin, oral).

Documentation should explain why existing subcategories do not adequately capture the complication.

The causal relationship to drug-induced diabetes must be established.

Audit Caution

HCC Buddy guidance

This catch-all code should be the last choice after ruling out all specific complication codes.

Provider query is recommended to determine if a more specific code applies.

Using this code when a specific complication code exists reduces documentation quality and may trigger payer audits.

Common Mistakes

HCC Buddy guidance

More specific E09 complication codes (E09.21-E09.65) should be used when the complication fits those categories. E09.8 (unspecified complications) represents less specificity than E09.

E13.69 (other specified diabetes with other specified complication) applies to other specified diabetes types, not drug-induced.

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 E09.69 an HCC code?

Yes. E09.69 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 E09.69

For E09.69to 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 E09.69 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

E09.69 is the ICD-10-CM diagnosis code for drug or chemical induced diabetes mellitus with other specified complication. Diabetes caused by medications or chemicals with other complications not specifically listed, such as complications affecting multiple body systems. E09.69 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, E09.69 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.

Use this code only when the complication doesn't fit into more specific E09 subcategories. Because E09.69 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 E09.69 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when the complication doesn't fit into more specific E09 subcategories
•Clearly document the nature of the complication in the medical record

Clinical Significance

Drug or chemical induced diabetes mellitus with other specified complication captures diabetic complications that do not fit standard subcategories involving specific organ systems. This may include hypoglycemia unawareness, insulin injection site lipodystrophy, or complications affecting multiple organ systems simultaneously. This code indicates a complex clinical picture requiring individualized management strategies.

Documentation Requirements

✓The causative drug or chemical must be identified.
✓The specific complication must be clearly described and differentiated from complications with dedicated codes (renal, ophthalmic, neurological, circulatory, skin, oral).
✓Documentation should explain why existing subcategories do not adequately capture the complication.
✓The causal relationship to drug-induced diabetes must be established.

Use Additional Code

code to identify complication

Commonly Confused Codes

•More specific E09 complication codes (E09.21-E09.65) should be used when the complication fits those categories. E09.8 (unspecified complications) represents less specificity than E09.
•E13.69 (other specified diabetes with other specified complication) applies to other specified diabetes types, not drug-induced.