What is ICD-10 code E11.620?

E11.620 is the ICD-10-CM diagnosis code for Type 2 diabetes mellitus with diabetic dermatitis. Type 2 diabetes causing skin inflammation and irritation, typically resulting from high blood sugar levels. It belongs to the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89). E11.620 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E11.620 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. E11.620 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. E11.620 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 E11.620?

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. For E11.620, V28 maps to Diabetes with Chronic Complications at RAF 0.166 while V24 mapped to Diabetes with Chronic Complications at RAF 0.302. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting E11.620?

Document the specific type and location of dermatitis to support medical necessity Ensure the dermatitis is confirmed as diabetic-related rather than another etiology Because E11.620 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.

2026 ICD-10-CM E11.620: Type 2 diabetes mellitus

ICD-10-CM Code View

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Code lookupE11.620Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

E11.620

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

Type 2 diabetes mellitus with diabetic dermatitis

Type 2 diabetes causing skin inflammation and irritation, typically resulting from high blood sugar levels.

Buddy Insight

CMS-HCC V28

Mapped

HCC 37

Diabetes with Chronic Complic...

RAF 0.166

CMS-HCC V24

Mapped

HCC 18

Diabetes with Chronic Complic...

RAF 0.302

ACA/HHS

Mapped

HCC 20

HHS-HCC 20

Varies by metal level

ESRD/PACE

Mapped

HCC 18

Diabetes with Chronic Complic...

RAF 0.084

RXHCC

Mapped

HCC 30

Diabetes with Complications

RAF 0.495

Code Book Path

Official

E11.6Type 2 diabetes mellitus with other specified complications

E11.62Type 2 diabetes mellitus with skin complications

E11.620Type 2 diabetes mellitus with diabetic dermatitis

Inclusion Terms

Official

Type 2 diabetes mellitus with diabetic necrobiosis lipoidica

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E11.620 in this effective period.

Related Child Codes

Official

E11.621Type 2 diabetes mellitus with foot ulcer

E11.622Type 2 diabetes mellitus with other skin ulcer

E11.628Type 2 diabetes mellitus with other skin complications

Includes

Official

ICD-10-CM does not list Includes notes for E11.620 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for E11.620 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E11.620 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for E11.620 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for E11.620 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation must identify the specific dermatitis condition and link it to Type 2 diabetes.

The provider should describe the location, appearance, extent, and any associated symptoms or functional impact.

Biopsy results should be included when obtained.

The record must clearly distinguish dermatitis (inflammatory skin changes) from ulceration (open wounds) and other skin complications.

MEAT Support

HCC Buddy guidance

Documentation must identify the specific dermatitis condition and link it to Type 2 diabetes.

The provider should describe the location, appearance, extent, and any associated symptoms or functional impact.

Biopsy results should be included when obtained.

The record must clearly distinguish dermatitis (inflammatory skin changes) from ulceration (open wounds) and other skin complications.

Audit Caution

HCC Buddy guidance

Differentiate between dermatitis (inflammatory, intact skin) and ulceration (open wound), as these have different codes and clinical management pathways. Not all skin conditions in diabetic patients are diabetic dermatitis

the provider must establish the causal link. This combination code captures both conditions

do not code them separately.

Common Mistakes

HCC Buddy guidance

E11.621/E11.622 (foot ulcer/other skin ulcer) represent open wound complications, not inflammatory conditions.

E11.628 (other skin complications) covers skin manifestations not classified as dermatitis.

L30.9 (dermatitis, unspecified) does not capture the diabetic etiology.

E11.69 (other specified complication) is too broad when skin inflammation is specifically documented.

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 E11.620 an HCC code?

Yes. E11.620 (Type 2 diabetes mellitus with diabetic dermatitis) maps to Diabetes with Chronic 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: E11.620 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: E11.620
Description: Type 2 diabetes mellitus with diabetic dermatitis
HCC (V28): HCC 37 — Diabetes with Chronic Complications
RAF: 0.166
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 37, Diabetes with Chronic Complications

0.166

V24HCC 18, Diabetes with Chronic Complications

0.302

ESRDHCC 18, Diabetes with Chronic Complications

0.084

RxHCCHCC 30, Diabetes with Complications

0.495

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 E11.620 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for E11.620

For E11.620 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 E11.620 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

E11.620 is the ICD-10-CM diagnosis code for type 2 diabetes mellitus with diabetic dermatitis. Type 2 diabetes causing skin inflammation and irritation, typically resulting from high blood sugar levels. E11.620 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, E11.620 maps to Diabetes with Chronic Complications (HCC 37) with a community, non-dual, aged base RAF weight of 0.166. Under the older V24 model, E11.620 mapped to the same category but with a base RAF weight of 0.302, V28 recalibrated weights across the entire model. 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.

Document the specific type and location of dermatitis to support medical necessity. Because E11.620 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 E11.620 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document the specific type and location of dermatitis to support medical necessity
•Ensure the dermatitis is confirmed as diabetic-related rather than another etiology

Clinical Significance

Type 2 diabetes mellitus with diabetic dermatitis encompasses inflammatory skin conditions directly attributable to diabetes, including necrobiosis lipoidica diabeticorum, diabetic dermopathy (shin spots), granuloma annulare, and diabetic thick skin. These skin manifestations often correlate with glycemic control quality and may serve as visible markers of underlying microvascular disease. While typically not life-threatening, they impact quality of life and may complicate wound healing.

Documentation Requirements

✓Documentation must identify the specific dermatitis condition and link it to Type 2 diabetes.
✓The provider should describe the location, appearance, extent, and any associated symptoms or functional impact.
✓Biopsy results should be included when obtained.
✓The record must clearly distinguish dermatitis (inflammatory skin changes) from ulceration (open wounds) and other skin complications.

Commonly Confused Codes

•E11.621/E11.622 (foot ulcer/other skin ulcer) represent open wound complications, not inflammatory conditions.
•E11.628 (other skin complications) covers skin manifestations not classified as dermatitis.
•L30.9 (dermatitis, unspecified) does not capture the diabetic etiology.
•E11.69 (other specified complication) is too broad when skin inflammation is specifically documented.