E10.8
BillableType 1 diabetes mellitus with unspecified complications
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E10.8 an HCC code?
Yes. E10.8 maps to Diabetes without Complication 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 E10.8
For E10.8 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 E10.8 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E10.8 is the ICD-10-CM diagnosis code for type 1 diabetes mellitus with unspecified complications. Type 1 diabetes with complications that are present but not specifically identified or documented. E10.8 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, E10.8 maps to Diabetes without Complication (HCC 38) with a community, non-dual, aged base RAF weight of 0.450. Under the older CMS-HCC V24 model, E10.8 maps to Diabetes with Chronic Complications (HCC 18) with a community, non-dual, aged base RAF weight of 0.302. 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.
Query the provider to identify the specific complication rather than using this unspecified code when possible. Because E10.8 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 E10.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Query the provider to identify the specific complication rather than using this unspecified code when possible
- •Use only when documentation is truly unclear about which complication is present
Clinical Significance
Type 1 diabetes mellitus with unspecified complications indicates that diabetic complications are present but not further characterized in the medical record. This code signals incomplete documentation that may underrepresent the patient's true disease burden. While it does capture HCC value, it provides limited clinical utility for care management and quality measurement.
Documentation Requirements
- ✓This code requires documentation of Type 1 diabetes with at least one complication present, even though the specific complication is not identified.
- ✓Coders should query the provider to identify the specific complication(s) before defaulting to this unspecified code.
- ✓If the complication cannot be further specified after query, the documentation should explain why specificity could not be achieved.