E11.29 ICD-10-CM Code: Type 2 diabetes mellitus with other diabetic kidney complication
E11.29 maps to CMS-HCC V28 37. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Diabetes mellitus (E08-E13)
E11.29
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceType 2 diabetes mellitus with other diabetic kidney complication
Type 2 diabetes with other kidney complications besides the main types, such as diabetic glomerulonephritis or other kidney disorders caused by diabetes.
Buddy Insight
Type 2 diabetes mellitus with other diabetic kidney complication captures renal conditions attributable to diabetes that are not classified as nephropathy or chronic kidney disease, such as Kimmelstiel-Wilson disease (nodular diabetic glomerulosclerosis), diabetic papillary necrosis, or other specific renal pathology from diabetes.
CMS-HCC V28
MappedHCC 37
Code-level coefficient reference
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 020
Code-level coefficient reference
ESRD/PACE
MappedHCC 18
Code-level coefficient reference
RXHCC
MappedHCC 30
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Type 2 diabetes mellitus with renal tubular degeneration
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E11.29 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for E11.29 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for E11.29 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E11.29 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for E11.29 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for E11.29 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 E11.29 an HCC code?
Yes. E11.29 (Type 2 diabetes mellitus with other diabetic kidney complication) maps to HCC 37, Diabetes with Chronic Complications under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.166. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: E11.29 is billable and maps to V28 HCC 37, Diabetes with Chronic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- E11.29
- Description
- Type 2 diabetes mellitus with other diabetic kidney complication
- HCC (V28)
- HCC 37 — Diabetes with Chronic Complications
- RAF reference coefficient
- 0.166
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work E11.29 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT Criteria for E11.29
For E11.29 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 E11.29 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
E11.29 is the ICD-10-CM diagnosis code for type 2 diabetes mellitus with other diabetic kidney complication. Type 2 diabetes with other kidney complications besides the main types, such as diabetic glomerulonephritis or other kidney disorders caused by diabetes. E11.29 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, E11.29 maps to Diabetes with Chronic Complications (HCC 37) with a source-labeled community, non-dual, aged reference coefficient of 0.166. No V24 mapping is shown for E11.29; use the applicable model and payment year when reviewing the V28 mapping. 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. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Use E11.29 when the provider wording supports type 2 diabetes mellitus with other diabetic kidney complication. Check the FY2026 tabular notes and the full code path before the final code choice. Because E11.29 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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, source-labeled coefficient references, and MEAT documentation criteria for E11.29 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use E11.29 when the provider wording supports type 2 diabetes mellitus with other diabetic kidney complication. Check the FY2026 tabular notes and the full code path before the final code choice.
- •For this DOS, capture the provider's current assessment and the care action documented for type 2 diabetes mellitus with other diabetic kidney complication. Keep the checklist tied to the note.
- •Do not swap E11.29 with E11.21. The FY2026 tabular describes E11.21 as type 2 diabetes mellitus with diabetic nephropathy. Follow the documented detail.
- •The FY2026 Alphabetic Index routes Diabetes, diabetic (mellitus) (sugar) with kidney complications NEC to E11.29. Confirm that the indexed wording matches the provider documentation before using this route.
- •Ask Buddy to show the official notes for E11.29 or compare its code path with E11.21.
Clinical Significance
Type 2 diabetes mellitus with other diabetic kidney complication captures renal conditions attributable to diabetes that are not classified as nephropathy or chronic kidney disease, such as Kimmelstiel-Wilson disease (nodular diabetic glomerulosclerosis), diabetic papillary necrosis, or other specific renal pathology from diabetes. These conditions indicate significant renal microvascular damage requiring specialized nephrology management.
Documentation Requirements
- ✓The medical record must identify the specific renal complication and establish its causal relationship to Type 2 diabetes.
- ✓Kidney biopsy results, if obtained, should be documented along with renal function tests and imaging findings.
- ✓The provider must confirm the condition does not fit the nephropathy (E11.21) or chronic kidney disease (E11.22) categories.
Commonly Confused Codes
- •E11.21 (diabetic nephropathy) is the most common diabetic renal code and should be used when nephropathy is documented.
- •E11.22 (diabetic chronic kidney disease) is for staged CKD attributable to diabetes.
- •N08 (glomerular disorders in diseases classified elsewhere) may be used as an additional manifestation code alongside this combination code.