E10.8 ICD-10-CM Code: Type 1 diabetes mellitus with unspecified complications
HCC Buddy Code Card
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Diabetes mellitus (E08-E13)
E10.8
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceType 1 diabetes mellitus with unspecified complications
Type 1 diabetes with complications that are present but not specifically identified or documented.
Buddy Insight
Type 1 diabetes mellitus with unspecified complications indicates that diabetic complications are present but not further characterized in the medical record.
CMS-HCC V28
MappedHCC 38
RAF 0.166
CMS-HCC V24
MappedHCC 18
RAF 0.302
ACA/HHS
N/A—
Not mapped
ESRD/PACE
MappedHCC 18
RAF 0.084
RXHCC
MappedHCC 30
RAF 0.495
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for E10.8 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E10.8 in this effective period.
Related Child Codes
Includes
Official- brittle diabetes (mellitus)
- diabetes (mellitus) due to autoimmune process
- diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction
- idiopathic diabetes (mellitus)
- juvenile onset diabetes (mellitus)
Excludes 1
Official- diabetes mellitus due to underlying condition (E08.-)
- drug or chemical induced diabetes mellitus (E09.-)
- gestational diabetes (O24.4-)
- hyperglycemia NOS (R73.9)
- neonatal diabetes mellitus (P70.2)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E10.8 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for E10.8 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for E10.8 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is E10.8 an HCC code?
Yes. E10.8 (Type 1 diabetes mellitus with unspecified complications) maps to Diabetes with No, Glycemic, or Unspecified Complications under the CMS-HCC V28 risk adjustment model (and Diabetes with Chronic Complications under V24), with a community non-dual aged RAF of 0.166. It is billable for payment year 2026.
Coder answer: E10.8 is billable and maps to V28 HCC 38, Diabetes with No, Glycemic, or Unspecified Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- E10.8
- Description
- Type 1 diabetes mellitus with unspecified complications
- HCC (V28)
- HCC 38 — Diabetes with No, Glycemic, or Unspecified Complications
- RAF
- 0.166
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. 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.
Work E10.8 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
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.
Coder workflow notes
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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 with No, Glycemic, or Unspecified Complications (HCC 38) with a community, non-dual, aged base RAF weight of 0.166. 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.
Commonly Confused Codes
- •E10.69 (other specified complication) is used when the complication is identified but does not fit specific subcategories.
- •E10.9 (without complications) is used when no complications are documented.
- •Any specific E10.0-E10.6x code should be used over this unspecified code when the complication is identified.