What is ICD-10 code E10.69?

E10.69 is the ICD-10-CM diagnosis code for Type 1 diabetes mellitus with other specified complication. Type 1 diabetes with other diabetes-related complications not covered by more specific codes. It belongs to the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89). E10.69 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E10.69 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. E10.69 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. E10.69 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for E10.69?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For E10.69, V28 maps to Diabetes with Chronic Complications at RAF 0.245 while V24 mapped to Diabetes with Chronic Complications at RAF 0.302. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting E10.69?

Use this code only when the specific complication doesn't fit other E10 subcategories Document the specific complication clearly so it can be coded more precisely if applicable Because E10.69 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.

E10.69 ICD-10 Code: Type 1 diabetes mellitus

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupE10.69Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

E10.69

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

Type 1 diabetes mellitus with other specified complication

Type 1 diabetes with other diabetes-related complications not covered by more specific codes.

Buddy Insight

Type 1 diabetes mellitus with other specified complication is a residual code for documented diabetes complications that do not fit any of the specific subcategories in the E10 code set.

CMS-HCC V28

Mapped

HCC 37

Diabetes with Chronic Complic...

RAF 0.245

CMS-HCC V24

Mapped

HCC 18

Diabetes with Chronic Complic...

RAF 0.302

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 18

Diabetes with Chronic Complic...

RAF 0.0

RXHCC

Mapped

HCC 30

Diabetes with Complications

RAF 0.0

Code Trumping

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Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

E10Type 1 diabetes mellitus

E10.6Type 1 diabetes mellitus with other specified complications

E10.69Type 1 diabetes mellitus with other specified complication

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for E10.69 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E10.69 in this effective period.

Related Child Codes

Official

E10.61Type 1 diabetes mellitus with diabetic arthropathy

E10.62Type 1 diabetes mellitus with skin complications

E10.63Type 1 diabetes mellitus with oral complications

E10.64Type 1 diabetes mellitus with hypoglycemia

E10.65Type 1 diabetes mellitus with hyperglycemia

Includes

Official

ICD-10-CM does not list Includes notes for E10.69 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for E10.69 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E10.69 in this effective period.

Use Additional

Official

code to identify complication

Code Also

Official

ICD-10-CM does not list Code Also instructions for E10.69 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

The provider must clearly document the specific complication and its causal link to Type 1 diabetes.

The record should describe the nature, severity, and impact of the complication.

Documentation should confirm the condition does not fit a more specific E10 subcategory (renal, ophthalmic, neurological, circulatory, or skin) to justify use of this residual code.

MEAT Support

HCC Buddy guidance

The provider must clearly document the specific complication and its causal link to Type 1 diabetes.

The record should describe the nature, severity, and impact of the complication.

Documentation should confirm the condition does not fit a more specific E10 subcategory (renal, ophthalmic, neurological, circulatory, or skin) to justify use of this residual code.

Audit Caution

HCC Buddy guidance

This code should be a last resort after confirming no more specific diabetes complication code applies.

Do not use this code when the complication fits a specific subcategory that the coder has overlooked.

Always query the provider for additional specificity before defaulting to this residual code.

Common Mistakes

HCC Buddy guidance

E10.8 (unspecified complications) is used when a complication is present but not identified

E10.69 requires the complication to be specified but not classifiable elsewhere. E10.59 (other circulatory complications) or E10.49 (other neurological complications) should be used when those organ systems are specifically involved. E10.9 (without complications) is incorrect when any complication is documented.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is E10.69 an HCC code?

Yes. E10.69 maps to Diabetes with Chronic Complications under the CMS-HCC V28 risk adjustment model (and Diabetes with Chronic Complications under V24).

HCC Category Mapping

V28HCC 37, Diabetes with Chronic Complications

0.245

V24HCC 18, Diabetes with Chronic Complications

0.302

ESRDHCC 18, Diabetes with Chronic Complications

0.000

RxHCCHCC 30, Diabetes with Complications

0.000

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 E10.69

For E10.69to 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 E10.69 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

E10.69 is the ICD-10-CM diagnosis code for type 1 diabetes mellitus with other specified complication. Type 1 diabetes with other diabetes-related complications not covered by more specific codes. E10.69 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, E10.69 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, E10.69 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.

Use this code only when the specific complication doesn't fit other E10 subcategories. Because E10.69 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 E10.69 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when the specific complication doesn't fit other E10 subcategories
•Document the specific complication clearly so it can be coded more precisely if applicable

Clinical Significance

Type 1 diabetes mellitus with other specified complication is a residual code for documented diabetes complications that do not fit any of the specific subcategories in the E10 code set. Examples include diabetic mastopathy, diabetic cardiomyopathy, or diabetic hepatopathy. These conditions indicate multisystem involvement from chronic diabetes and require targeted management beyond standard glycemic control.

Documentation Requirements

✓The provider must clearly document the specific complication and its causal link to Type 1 diabetes.
✓The record should describe the nature, severity, and impact of the complication.
✓Documentation should confirm the condition does not fit a more specific E10 subcategory (renal, ophthalmic, neurological, circulatory, or skin) to justify use of this residual code.

Use Additional Code

code to identify complication

Commonly Confused Codes

•E10.8 (unspecified complications) is used when a complication is present but not identified
•E10.69 requires the complication to be specified but not classifiable elsewhere. E10.59 (other circulatory complications) or E10.49 (other neurological complications) should be used when those organ systems are specifically involved. E10.9 (without complications) is incorrect when any complication is documented.