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E11 ICD-10-CM Code: Type 2 diabetes mellitus

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

E11

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Type 2 diabetes mellitus

Type 2 diabetes mellitus

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
E1Diabetes mellitus (E08-E13)
E11Type 2 diabetes mellitus

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for E11 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E11 in this effective period.

Related Child Codes

Official
E11.0Type 2 diabetes mellitus with hyperosmolarity
E11.1Type 2 diabetes mellitus with ketoacidosis
E11.2Type 2 diabetes mellitus with kidney complications
E11.3Type 2 diabetes mellitus with ophthalmic complications
E11.4Type 2 diabetes mellitus with neurological complications

Includes

Official
  • diabetes (mellitus) due to insulin secretory defect
  • diabetes NOS
  • insulin resistant diabetes (mellitus)

Excludes 1

Official
  • diabetes mellitus due to underlying condition (E08.-)
  • drug or chemical induced diabetes mellitus (E09.-)
  • gestational diabetes (O24.4-)
  • neonatal diabetes mellitus (P70.2)
  • postpancreatectomy diabetes mellitus (E13.-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E11 in this effective period.

Use Additional

Official
  • code to identify control using:
  • injectable non-insulin antidiabetic drugs (Z79.85)
  • insulin (Z79.4)
  • oral antidiabetic drugs (Z79.84)
  • oral hypoglycemic drugs (Z79.84)

Code Also

Official

ICD-10-CM does not list Code Also instructions for E11 in this effective period.

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.

What This Code Means

E11 is the ICD-10-CM diagnosis code for type 2 diabetes mellitus. E11 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering diabetes mellitus (e08-e13).

Header codes like E11 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at E11's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • diabetes (mellitus) due to insulin secretory defect
  • diabetes NOS
  • insulin resistant diabetes (mellitus)

Excludes 1, Do NOT code together

  • diabetes mellitus due to underlying condition (E08.-)
  • drug or chemical induced diabetes mellitus (E09.-)
  • gestational diabetes (O24.4-)
  • neonatal diabetes mellitus (P70.2)
  • postpancreatectomy diabetes mellitus (E13.-)
  • postprocedural diabetes mellitus (E13.-)
  • secondary diabetes mellitus NEC (E13.-)
  • type 1 diabetes mellitus (E10.-)

Use Additional Code

  • code to identify control using:
  • injectable non-insulin antidiabetic drugs (Z79.85)
  • insulin (Z79.4)
  • oral antidiabetic drugs (Z79.84)
  • oral hypoglycemic drugs (Z79.84)

Child Codes

Code Hierarchy

E11Type 2 diabetes mellitus
E11Type 2 diabetes mellitus

More on E11

Related condition guides

Referenced in blog posts

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