ICD-10-CM category E11
Type 2 diabetes mellitus: every E11 code with its CMS-HCC V28 status
E11, Type 2 diabetes mellitus, holds 117 codes in the FY2026 ICD-10-CM set: 87 billable codes and 30 header codes that need a further character. 86 of them maps to a CMS-HCC V28 payment category (HCC 36, 37, 38, 263, 298, and 383) for payment year 2026. The other 1 billable code carries no V28 HCC and does not risk-adjust.
E1187 billable codes (FY2026)86 map to CMS-HCC V28
CMS-HCC V28 categories in E11 (6)
Coefficients are the code-level reference values from the CMS V28 factor file (community, non-dual, aged), not a member's score. Hierarchy, interactions, and enrollment segment decide what a documented condition contributes.
- HCC 37 Diabetes with Chronic Complications77 codes · ref. 0.166
- HCC 298 Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage37 codes · ref. 0.336
- HCC 36 Diabetes with Severe Acute Complications5 codes · ref. 0.166
- HCC 38 Diabetes with No, Glycemic, or Unspecified Complications4 codes · ref. 0.166
- HCC 383 Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle2 codes · ref. 0.646
- HCC 263 Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene1 code · ref. 1.118
All 117 E11 codes (FY2026)
Descriptors are the FY2026 order-file text. Header codes need a further character and cannot be reported; open any billable code for its tabular notes, MEAT guidance, and mapping detail.
| Code | Description | FY2026 | CMS-HCC V28 |
|---|---|---|---|
| E11 | Type 2 diabetes mellitus | Header | Header code, not reportable |
| E11.0 | Type 2 diabetes mellitus with hyperosmolarity | Header | Header code, not reportable |
| E11.00 | Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) | Billable | HCC 36 |
| E11.01 | Type 2 diabetes mellitus with hyperosmolarity with coma | Billable | HCC 36 |
| E11.1 | Type 2 diabetes mellitus with ketoacidosis | Header | Header code, not reportable |
| E11.10 | Type 2 diabetes mellitus with ketoacidosis without coma | Billable | HCC 36 |
| E11.11 | Type 2 diabetes mellitus with ketoacidosis with coma | Billable | HCC 36 |
| E11.2 | Type 2 diabetes mellitus with kidney complications | Header | Header code, not reportable |
| E11.21 | Type 2 diabetes mellitus with diabetic nephropathy | Billable | HCC 37 |
| E11.22 | Type 2 diabetes mellitus with diabetic chronic kidney disease | Billable | HCC 37 |
| E11.29 | Type 2 diabetes mellitus with other diabetic kidney complication | Billable | HCC 37 |
| E11.3 | Type 2 diabetes mellitus with ophthalmic complications | Header | Header code, not reportable |
| E11.31 | Type 2 diabetes mellitus with unspecified diabetic retinopathy | Header | Header code, not reportable |
| E11.311 | Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema | Billable | HCC 37, HCC 298 |
| E11.319 | Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | Billable | HCC 37 |
| E11.32 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy | Header | Header code, not reportable |
| E11.321 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema | Header | Header code, not reportable |
| E11.3211 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye | Billable | HCC 37, HCC 298 |
| E11.3212 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye | Billable | HCC 37, HCC 298 |
| E11.3213 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral | Billable | HCC 37, HCC 298 |
| E11.3219 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye | Billable | HCC 37, HCC 298 |
| E11.329 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema | Header | Header code, not reportable |
| E11.3291 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye | Billable | HCC 37 |
| E11.3292 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye | Billable | HCC 37 |
| E11.3293 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral | Billable | HCC 37 |
| E11.3299 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye | Billable | HCC 37 |
| E11.33 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy | Header | Header code, not reportable |
| E11.331 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema | Header | Header code, not reportable |
| E11.3311 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye | Billable | HCC 37, HCC 298 |
| E11.3312 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye | Billable | HCC 37, HCC 298 |
| E11.3313 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral | Billable | HCC 37, HCC 298 |
| E11.3319 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye | Billable | HCC 37, HCC 298 |
| E11.339 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema | Header | Header code, not reportable |
| E11.3391 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye | Billable | HCC 37 |
| E11.3392 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye | Billable | HCC 37 |
| E11.3393 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral | Billable | HCC 37 |
| E11.3399 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye | Billable | HCC 37 |
| E11.34 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy | Header | Header code, not reportable |
| E11.341 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema | Header | Header code, not reportable |
| E11.3411 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye | Billable | HCC 37, HCC 298 |
| E11.3412 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye | Billable | HCC 37, HCC 298 |
| E11.3413 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral | Billable | HCC 37, HCC 298 |
| E11.3419 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye | Billable | HCC 37, HCC 298 |
| E11.349 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema | Header | Header code, not reportable |
| E11.3491 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye | Billable | HCC 37 |
| E11.3492 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye | Billable | HCC 37 |
| E11.3493 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral | Billable | HCC 37 |
| E11.3499 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye | Billable | HCC 37 |
| E11.35 | Type 2 diabetes mellitus with proliferative diabetic retinopathy | Header | Header code, not reportable |
| E11.351 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema | Header | Header code, not reportable |
| E11.3511 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye | Billable | HCC 37, HCC 298 |
| E11.3512 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye | Billable | HCC 37, HCC 298 |
| E11.3513 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral | Billable | HCC 37, HCC 298 |
| E11.3519 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye | Billable | HCC 37, HCC 298 |
| E11.352 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula | Header | Header code, not reportable |
| E11.3521 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye | Billable | HCC 37, HCC 298 |
| E11.3522 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye | Billable | HCC 37, HCC 298 |
| E11.3523 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral | Billable | HCC 37, HCC 298 |
| E11.3529 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye | Billable | HCC 37, HCC 298 |
| E11.353 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula | Header | Header code, not reportable |
| E11.3531 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye | Billable | HCC 37, HCC 298 |
| E11.3532 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye | Billable | HCC 37, HCC 298 |
| E11.3533 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral | Billable | HCC 37, HCC 298 |
| E11.3539 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye | Billable | HCC 37, HCC 298 |
| E11.354 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment | Header | Header code, not reportable |
| E11.3541 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye | Billable | HCC 37, HCC 298 |
| E11.3542 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye | Billable | HCC 37, HCC 298 |
| E11.3543 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral | Billable | HCC 37, HCC 298 |
| E11.3549 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye | Billable | HCC 37, HCC 298 |
| E11.355 | Type 2 diabetes mellitus with stable proliferative diabetic retinopathy | Header | Header code, not reportable |
| E11.3551 | Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye | Billable | HCC 37, HCC 298 |
| E11.3552 | Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye | Billable | HCC 37, HCC 298 |
| E11.3553 | Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral | Billable | HCC 37, HCC 298 |
| E11.3559 | Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye | Billable | HCC 37, HCC 298 |
| E11.359 | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema | Header | Header code, not reportable |
| E11.3591 | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye | Billable | HCC 37, HCC 298 |
| E11.3592 | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye | Billable | HCC 37, HCC 298 |
| E11.3593 | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral | Billable | HCC 37, HCC 298 |
| E11.3599 | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye | Billable | HCC 37, HCC 298 |
| E11.36 | Type 2 diabetes mellitus with diabetic cataract | Billable | HCC 37 |
| E11.37 | Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment | Header | Header code, not reportable |
| E11.37X1 | Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye | Billable | HCC 37 |
| E11.37X2 | Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye | Billable | HCC 37 |
| E11.37X3 | Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral | Billable | HCC 37 |
| E11.37X9 | Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye | Billable | HCC 37 |
| E11.39 | Type 2 diabetes mellitus with other diabetic ophthalmic complication | Billable | HCC 37 |
| E11.4 | Type 2 diabetes mellitus with neurological complications | Header | Header code, not reportable |
| E11.40 | Type 2 diabetes mellitus with diabetic neuropathy, unspecified | Billable | HCC 37 |
| E11.41 | Type 2 diabetes mellitus with diabetic mononeuropathy | Billable | HCC 37 |
| E11.42 | Type 2 diabetes mellitus with diabetic polyneuropathy | Billable | HCC 37 |
| E11.43 | Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy | Billable | HCC 37 |
| E11.44 | Type 2 diabetes mellitus with diabetic amyotrophy | Billable | HCC 37 |
| E11.49 | Type 2 diabetes mellitus with other diabetic neurological complication | Billable | HCC 37 |
| E11.5 | Type 2 diabetes mellitus with circulatory complications | Header | Header code, not reportable |
| E11.51 | Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene | Billable | HCC 37 |
| E11.52 | Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene | Billable | HCC 37, HCC 263 |
| E11.59 | Type 2 diabetes mellitus with other circulatory complications | Billable | HCC 37 |
| E11.6 | Type 2 diabetes mellitus with other specified complications | Header | Header code, not reportable |
| E11.61 | Type 2 diabetes mellitus with diabetic arthropathy | Header | Header code, not reportable |
| E11.610 | Type 2 diabetes mellitus with diabetic neuropathic arthropathy | Billable | HCC 37 |
| E11.618 | Type 2 diabetes mellitus with other diabetic arthropathy | Billable | HCC 37 |
| E11.62 | Type 2 diabetes mellitus with skin complications | Header | Header code, not reportable |
| E11.620 | Type 2 diabetes mellitus with diabetic dermatitis | Billable | HCC 37 |
| E11.621 | Type 2 diabetes mellitus with foot ulcer | Billable | HCC 37, HCC 383 |
| E11.622 | Type 2 diabetes mellitus with other skin ulcer | Billable | HCC 37, HCC 383 |
| E11.628 | Type 2 diabetes mellitus with other skin complications | Billable | HCC 37 |
| E11.63 | Type 2 diabetes mellitus with oral complications | Header | Header code, not reportable |
| E11.630 | Type 2 diabetes mellitus with periodontal disease | Billable | HCC 37 |
| E11.638 | Type 2 diabetes mellitus with other oral complications | Billable | HCC 37 |
| E11.64 | Type 2 diabetes mellitus with hypoglycemia | Header | Header code, not reportable |
| E11.641 | Type 2 diabetes mellitus with hypoglycemia with coma | Billable | HCC 36 |
| E11.649 | Type 2 diabetes mellitus with hypoglycemia without coma | Billable | HCC 38 |
| E11.65 | Type 2 diabetes mellitus with hyperglycemia | Billable | HCC 38 |
| E11.69 | Type 2 diabetes mellitus with other specified complication | Billable | HCC 37 |
| E11.8 | Type 2 diabetes mellitus with unspecified complications | Billable | HCC 38 |
| E11.9 | Type 2 diabetes mellitus without complications | Billable | HCC 38 |
| E11.A | Type 2 diabetes mellitus without complications in remission | Billable | No V28 HCC |
Documentation guides for E11
Frequently asked questions
How many E11 codes are there?
The E11 category (Type 2 diabetes mellitus) has 117 codes in the FY2026 ICD-10-CM order file: 87 billable and 30 header codes, counting the category itself. Only a billable code can be reported on a claim.
Which E11 codes map to an HCC under CMS-HCC V28?
86 billable codes in E11 map to HCC 36, 37, 38, 263, 298, and 383 in the CMS-HCC V28 model for payment year 2026. HCC 37 (Diabetes with Chronic Complications) carries the most, with 77 codes. The 1 billable code without a V28 category is marked "No V28 HCC" in the table.
Which E11 codes are not billable?
E11 itself and 29 subcategory codes are header codes that need a further character before they can be reported: E11.0 (Type 2 diabetes mellitus with hyperosmolarity), E11.1 (Type 2 diabetes mellitus with ketoacidosis), E11.2 (Type 2 diabetes mellitus with kidney complications), E11.3 (Type 2 diabetes mellitus with ophthalmic complications), E11.31 (Type 2 diabetes mellitus with unspecified diabetic retinopathy), E11.32 (Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy), E11.321 (Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema), E11.329 (Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema), and 21 more. Each one is listed in the table with the billable codes beneath it.
Source: FY2026 ICD-10-CM order file (FY 2026 Apr update) for codes, billability, and descriptors; CMS-HCC V28 PY2026 final ICD-10-CM mappings and relative factors for payment status. Table generated 2026-09-10.