What is ICD-10 code E11.51?

E11.51 is the ICD-10-CM diagnosis code for Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene. It belongs to the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89). E11.51 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E11.51 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. E11.51 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. E11.51 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for E11.51?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. E11.51 is a payment HCC under V28 (Diabetes with Chronic Complications) but was not retained as a payment HCC under V24. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting E11.51?

Confirm that gangrene is NOT present; if gangrene exists, use E11.52 instead Document the location and severity of peripheral angiopathy when available to support treatment decisions Because E11.51 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

E11.51 ICD-10 Code: Type 2 diabetes mellitus with

ICD-10-CM Code View

HCC Buddy Code Card

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Code lookupE11.51Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

E11.51

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene

Type 2 diabetes with narrowing or blockage of blood vessels in the legs and feet without tissue death (gangrene). This reduces blood flow and can cause pain, poor wound healing, or cold extremities.

Buddy Insight

Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene reflects macrovascular disease where chronic hyperglycemia accelerates atherosclerosis in the peripheral arterial system.

CMS-HCC V28

Mapped

HCC 37

Diabetes with Chronic Complic...

RAF 0.245

CMS-HCC V24

Not risk-adjusted for this model/period.

RAF 0

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Not risk-adjusted for this model/period.

RAF 0

RXHCC

Mapped

HCC 30

Diabetes with Complications

RAF 0.0

Code Trumping

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Code Book Path

Official

E11Type 2 diabetes mellitus

E11.5Type 2 diabetes mellitus with circulatory complications

E11.51Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for E11.51 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E11.51 in this effective period.

Related Child Codes

Official

E11.52Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene

E11.59Type 2 diabetes mellitus with other circulatory complications

Includes

Official

ICD-10-CM does not list Includes notes for E11.51 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for E11.51 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E11.51 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for E11.51 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for E11.51 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation must confirm peripheral angiopathy as a complication of Type 2 diabetes and explicitly state that gangrene is absent.

Vascular assessment including ankle-brachial index, pulse examination, or arterial duplex ultrasound findings should be recorded.

Symptom severity (Fontaine classification or Rutherford category) and treatment plan including medication, exercise therapy, or revascularization referral should be documented.

MEAT Support

HCC Buddy guidance

Documentation must confirm peripheral angiopathy as a complication of Type 2 diabetes and explicitly state that gangrene is absent.

Vascular assessment including ankle-brachial index, pulse examination, or arterial duplex ultrasound findings should be recorded.

Symptom severity (Fontaine classification or Rutherford category) and treatment plan including medication, exercise therapy, or revascularization referral should be documented.

Audit Caution

HCC Buddy guidance

This code maps to HCC 37 in V28 but not to any HCC in V24, creating a model-dependent risk adjustment gap. Carefully verify gangrene is absent throughout the medical record before assigning this code. Do not assume peripheral angiopathy from neuropathy documentation

these are distinct vascular versus neurological conditions requiring separate confirmation.

Common Mistakes

HCC Buddy guidance

E11.52 (with gangrene) is used when tissue necrosis is present.

I73.9 (peripheral vascular disease, unspecified) should not replace this combination code when diabetes is the underlying cause.

E11.59 (other circulatory complications) covers non-peripheral vascular circulatory conditions.

E11.621 (foot ulcer) may coexist but captures a different complication.

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.

Is E11.51 an HCC code?

Yes. E11.51 maps to Diabetes with Chronic Complications under the CMS-HCC V28 risk adjustment model.

HCC Category Mapping

V28HCC 37 — Diabetes with Chronic Complications

0.245

RxHCCHCC 30 — Diabetes with Complications

0.000

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 E11.51

For E11.51to 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 E11.51 during that encounter — not just copy-forwarded from a problem list.

What This Code Means

E11.51 is the ICD-10-CM diagnosis code for type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene. Type 2 diabetes with narrowing or blockage of blood vessels in the legs and feet without tissue death (gangrene). This reduces blood flow and can cause pain, poor wound healing, or cold extremities. E11.51 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, E11.51 maps to Diabetes with Chronic Complications (HCC 37) with a community, non-dual, aged base RAF weight of 0.245. E11.51 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. 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.

Confirm that gangrene is NOT present; if gangrene exists, use E11.52 instead. Because E11.51 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 E11.51 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Confirm that gangrene is NOT present; if gangrene exists, use E11.52 instead
•Document the location and severity of peripheral angiopathy when available to support treatment decisions

Clinical Significance

Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene reflects macrovascular disease where chronic hyperglycemia accelerates atherosclerosis in the peripheral arterial system. This condition causes intermittent claudication, rest pain, and poor wound healing, significantly increasing the risk for ulceration and amputation. Peripheral arterial disease in diabetic patients tends to affect more distal vessels compared to non-diabetic patients, making surgical revascularization more challenging.

Documentation Requirements

✓Documentation must confirm peripheral angiopathy as a complication of Type 2 diabetes and explicitly state that gangrene is absent.
✓Vascular assessment including ankle-brachial index, pulse examination, or arterial duplex ultrasound findings should be recorded.
✓Symptom severity (Fontaine classification or Rutherford category) and treatment plan including medication, exercise therapy, or revascularization referral should be documented.

Commonly Confused Codes

•E11.52 (with gangrene) is used when tissue necrosis is present.
•I73.9 (peripheral vascular disease, unspecified) should not replace this combination code when diabetes is the underlying cause.
•E11.59 (other circulatory complications) covers non-peripheral vascular circulatory conditions.
•E11.621 (foot ulcer) may coexist but captures a different complication.