E10.41
BillableType 1 diabetes mellitus with diabetic mononeuropathy
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E10.41 an HCC code?
Yes. E10.41 maps to Diabetes with Chronic Complications under the CMS-HCC V28 risk adjustment model (and Diabetes with Chronic Complications under V24).
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 E10.41
For E10.41 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 E10.41 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E10.41 is the ICD-10-CM diagnosis code for type 1 diabetes mellitus with diabetic mononeuropathy. Type 1 diabetes with damage to a single nerve or nerve group, causing weakness or pain in a specific area of the body. E10.41 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 CMS-HCC V28 risk adjustment model, E10.41 maps to Diabetes with Chronic Complications (HCC 37) with a community, non-dual, aged base RAF weight of 0.245. Under the older V24 model, E10.41 mapped to the same category but with a base RAF weight of 0.302 — V28 recalibrated weights across the entire model. 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 nerve is affected (e.g., cranial nerve, femoral nerve) when possible. Because E10.41 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 E10.41 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document which nerve is affected (e.g., cranial nerve, femoral nerve) when possible
- •Mononeuropathy is less common than polyneuropathy in diabetes but still significant
Clinical Significance
Type 1 diabetes mellitus with diabetic mononeuropathy involves damage to a single peripheral nerve, distinguishing it from the more common diffuse polyneuropathy. Common presentations include cranial nerve III palsy (causing ptosis and diplopia), carpal tunnel syndrome, ulnar neuropathy, or femoral neuropathy. Mononeuropathies in Type 1 diabetes are thought to result from vasa nervorum ischemia and often have acute or subacute onset, which may prompt urgent evaluation to exclude other causes such as stroke.
Documentation Requirements
- ✓Type 1 diabetes must be confirmed.
- ✓The specific nerve affected should be documented with corresponding clinical findings (motor deficits, sensory loss, pain distribution).
- ✓Electrodiagnostic studies (nerve conduction velocity, EMG) confirming focal nerve involvement should be referenced.
- ✓The provider must link the mononeuropathy to diabetes rather than entrapment, trauma, or other causes.
Commonly Confused Codes
- •E10.42 (polyneuropathy) involves diffuse multi-nerve damage.
- •E10.40 (unspecified neuropathy) lacks specificity.
- •E10.43 (autonomic neuropathy) involves the involuntary nervous system.
- •G56-G58 (mononeuropathy codes by site) may be coded additionally for nerve specification but should not replace this combination code.