E10.618
BillableType 1 diabetes mellitus with other diabetic arthropathy
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E10.618 an HCC code?
Yes. E10.618 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 E10.618
For E10.618 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 E10.618 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E10.618 is the ICD-10-CM diagnosis code for type 1 diabetes mellitus with other diabetic arthropathy. Type 1 diabetes with joint and bone problems other than Charcot joints, such as arthritis or joint damage caused by diabetes. E10.618 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, E10.618 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, E10.618 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.
Verify that the arthropathy is diabetic-related and not a separate primary joint condition. Because E10.618 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 E10.618 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify that the arthropathy is diabetic-related and not a separate primary joint condition
- •Document which joints are affected and the nature of the arthropathy
Clinical Significance
Type 1 diabetes mellitus with other diabetic arthropathy encompasses joint disorders caused by diabetes that are not neuropathic arthropathy (Charcot joint). This includes conditions such as diabetic cheiroarthropathy (limited joint mobility syndrome), adhesive capsulitis, or other diabetes-related joint stiffness and inflammation. These conditions reflect the systemic connective tissue effects of chronic hyperglycemia.
Documentation Requirements
- ✓The medical record must specify the type of arthropathy and link it to Type 1 diabetes.
- ✓Documentation should describe the affected joints, range of motion limitations, and functional impact.
- ✓The provider must distinguish this from neuropathic arthropathy (Charcot joint) and from primary musculoskeletal conditions unrelated to diabetes.