E10.620
BillableType 1 diabetes mellitus with diabetic dermatitis
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E10.620 an HCC code?
Yes. E10.620 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 E10.620
For E10.620 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 E10.620 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E10.620 is the ICD-10-CM diagnosis code for type 1 diabetes mellitus with diabetic dermatitis. Type 1 diabetes with diabetic dermatitis, an inflammatory skin condition caused by diabetes affecting the skin's integrity. E10.620 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, E10.620 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, E10.620 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 dermatitis from other skin complications like ulcers; dermatitis involves inflammation without necessarily breaking the skin. Because E10.620 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 E10.620 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Distinguish dermatitis from other skin complications like ulcers; dermatitis involves inflammation without necessarily breaking the skin
- •Document the location and severity of the dermatitis
Clinical Significance
Diabetic dermatitis in Type 1 diabetes mellitus represents inflammatory skin changes directly attributable to diabetes, including conditions such as necrobiosis lipoidica diabeticorum, diabetic dermopathy, or granuloma annulare. These skin manifestations can indicate poor glycemic control and systemic microvascular involvement. While often less severe than ulcerative complications, they signal ongoing tissue damage requiring dermatological management.
Documentation Requirements
- ✓Documentation must identify the specific dermatitis condition and establish its causal relationship to Type 1 diabetes.
- ✓The provider should record the location, appearance, extent, and any associated symptoms.
- ✓Biopsy results, if obtained, should be included.
- ✓The record must distinguish dermatitis (inflammatory skin changes) from skin ulceration, which uses different codes.
Commonly Confused Codes
- •E10.621 (foot ulcer) and E10.622 (other skin ulcer) represent open wound complications rather than inflammatory skin conditions.
- •E10.628 (other skin complications) covers skin manifestations not classified as dermatitis.
- •L30.9 (dermatitis, unspecified) should not replace this combination code when the condition is diabetic in origin.