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E10.51 ICD-10-CM Code: Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene

E10.51 maps to CMS-HCC V28 37 (RAF 0.166). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC coding tools

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

E10.51

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

Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene

Type 1 diabetes with blood vessel damage in the legs and feet that restricts blood flow, but without tissue death or gangrene.

Buddy the Bee presenting code insight

Buddy Insight

Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene indicates significant macrovascular disease where chronically elevated blood glucose has damaged the peripheral arterial system.

CMS-HCC V28

HCC 37

RAF 0.166

CMS-HCC V24

HCC 18

RAF 0.302

+ HCC 108

ACA/HHS

N/A

—

Not mapped

ESRD/PACE

HCC 18

RAF 0.084

+ HCC 108

RXHCC

HCC 30

RAF 0.495

Code Book Path

Official
E10Type 1 diabetes mellitus
E10.5Type 1 diabetes mellitus with circulatory complications
E10.51Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for E10.51 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E10.51 in this effective period.

Related Child Codes

Official
E10.52Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene
E10.59Type 1 diabetes mellitus with other circulatory complications

Includes

Official

ICD-10-CM does not list Includes notes for E10.51 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for E10.51 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E10.51 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for E10.51 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for E10.51 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Documentation must specify peripheral angiopathy or peripheral arterial disease as a complication of Type 1 diabetes, and must explicitly state that gangrene is absent.
Include vascular assessment findings such as ankle-brachial index results, pulse examination, or imaging studies.
The location and severity of vascular compromise should be recorded along with any treatment plan.

MEAT Support

HCC Buddy guidance
Documentation must specify peripheral angiopathy or peripheral arterial disease as a complication of Type 1 diabetes, and must explicitly state that gangrene is absent.
Include vascular assessment findings such as ankle-brachial index results, pulse examination, or imaging studies.
The location and severity of vascular compromise should be recorded along with any treatment plan.

Audit Caution

HCC Buddy guidance
Carefully confirm that gangrene is not documented anywhere in the record before assigning this code; even a small area of necrotic tissue changes the code to E10.
Do not assume peripheral angiopathy from peripheral neuropathy alone, as these are distinct vascular versus neurological complications. This code only maps to HCC in V28, not V24.

Common Mistakes

HCC Buddy guidance
E10.52 (with gangrene) is used when tissue necrosis is present and carries significantly different clinical implications.
I73.9 (peripheral vascular disease, unspecified) should not replace this code when the condition is diabetic in origin.
E10.59 (other circulatory complications) covers non-peripheral angiopathy circulatory problems.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is E10.51 an HCC code?

Yes. E10.51 (Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene) maps to Diabetes with Chronic Complications under the CMS-HCC V28 risk adjustment model (and Diabetes with Chronic Complications under V24), with a community non-dual aged RAF of 0.166. It is billable for payment year 2026.

Coder answer: E10.51 is billable and maps to V28 HCC 37, Diabetes with Chronic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
E10.51
Description
Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene
HCC (V28)
HCC 37 — Diabetes with Chronic Complications
RAF
0.166
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 37, Diabetes with Chronic Complications
0.166
V24HCC 18, Diabetes with Chronic Complications
0.302
+ HCC 108, Vascular Disease0.288
ESRDHCC 18, Diabetes with Chronic Complications
0.084
+ HCC 108, Vascular Disease0.073
RxHCCHCC 30, Diabetes with Complications
0.495

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work E10.51 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for E10.51

For E10.51 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 E10.51 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

E10.51 is the ICD-10-CM diagnosis code for type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene. Type 1 diabetes with blood vessel damage in the legs and feet that restricts blood flow, but without tissue death or gangrene. E10.51 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, E10.51 maps to Diabetes with Chronic Complications (HCC 37) with a community, non-dual, aged base RAF weight of 0.166. Under the older V24 model, E10.51 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.

Distinguish between E10.51 (without gangrene) and E10.52 (with gangrene) based on presence or absence of necrotic tissue. Because E10.51 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 E10.51 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Distinguish between E10.51 (without gangrene) and E10.52 (with gangrene) based on presence or absence of necrotic tissue
  • •Document the location and severity of peripheral angiopathy to support the diagnosis

Clinical Significance

Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene indicates significant macrovascular disease where chronically elevated blood glucose has damaged the peripheral arterial system. This leads to reduced blood flow to the extremities, causing claudication, poor wound healing, and increased infection risk. Early identification and management can prevent progression to gangrene and potential amputation.

Documentation Requirements

  • ✓Documentation must specify peripheral angiopathy or peripheral arterial disease as a complication of Type 1 diabetes, and must explicitly state that gangrene is absent.
  • ✓Include vascular assessment findings such as ankle-brachial index results, pulse examination, or imaging studies.
  • ✓The location and severity of vascular compromise should be recorded along with any treatment plan.

Commonly Confused Codes

  • •E10.52 (with gangrene) is used when tissue necrosis is present and carries significantly different clinical implications.
  • •I73.9 (peripheral vascular disease, unspecified) should not replace this code when the condition is diabetic in origin.
  • •E10.59 (other circulatory complications) covers non-peripheral angiopathy circulatory problems.

Child Codes

E10.51Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene
HCC 37
E10.52Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene
HCC 37
E10.59Type 1 diabetes mellitus with other circulatory complications
HCC 37

Code Hierarchy

└E10Type 1 diabetes mellitus└E10.5Type 1 diabetes mellitus with circulatory complications└E10.51Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene
└E10.51Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene

Because E10.51 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.

E10.51 maps to CMS-HCC V28 category 37, Diabetes with Chronic Complications. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. Because E10.51 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

Work E10.51 in HCC Buddy

Open E10.51 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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