E10.610
BillableType 1 diabetes mellitus with diabetic neuropathic arthropathy
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E10.610 an HCC code?
Yes. E10.610 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 E10.610
For E10.610 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 E10.610 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E10.610 is the ICD-10-CM diagnosis code for type 1 diabetes mellitus with diabetic neuropathic arthropathy. Type 1 diabetes mellitus with a complication affecting the joints and nerves, causing joint damage due to loss of sensation and protective pain response. This occurs when high blood sugar damages nerves, leading to joint deterioration without the patient feeling pain. E10.610 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 CMS-HCC V28 risk adjustment model, E10.610 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, E10.610 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.
This code includes both the diabetes diagnosis and the neuropathic arthropathy complication, so do not code them separately. Because E10.610 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 E10.610 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code includes both the diabetes diagnosis and the neuropathic arthropathy complication, so do not code them separately
- •Verify documentation specifies Type 1 diabetes (not Type 2) and confirm the arthropathy is neuropathic in nature; if the specific joint location is documented, you may need an additional anatomical code
Clinical Significance
Diabetic neuropathic arthropathy (Charcot joint) in Type 1 diabetes mellitus is a devastating musculoskeletal complication where loss of protective sensation leads to progressive joint destruction, most commonly in the midfoot. The combination of neuropathy, repetitive trauma, and impaired proprioception results in bone fragmentation, joint subluxation, and severe deformity. Without early detection and offloading, this condition can lead to amputation.
Documentation Requirements
- ✓Documentation must identify neuropathic arthropathy (Charcot joint) as a complication of Type 1 diabetes, specifying the affected joint(s) and clinical stage (acute inflammatory, coalescence, or reconstruction).
- ✓Imaging findings such as bone fragmentation, joint collapse, or deformity should be included.
- ✓Treatment documentation should note offloading devices, surgical interventions, or orthotic prescriptions.
Commonly Confused Codes
- •E10.618 (other diabetic arthropathy) covers joint problems that are not neuropathic in origin.
- •M14.60-M14.69 (Charcot joint) are manifestation codes that may be used additionally but do not replace the diabetes combination code.
- •E10.42 (diabetic polyneuropathy) captures the nerve damage component alone without the joint destruction.