E11.622
BillableType 2 diabetes mellitus with other skin ulcer
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E11.622 an HCC code?
No. E11.622 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
E11.622 is the ICD-10-CM diagnosis code for type 2 diabetes mellitus with other skin ulcer. Type 2 diabetes causing open sores or wounds on areas of the body other than the foot. E11.622 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering diabetes mellitus (e08-e13).
E11.622 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Does not map to any HCC in any model. Coders should ensure all associated diabetic complications (peripheral vascular disease, neuropathy) are captured with their own codes to maximize appropriate risk adjustment. Provider queries for concurrent conditions may be warranted. Coders reviewing E11.622 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC — capturing the correct specificity is the highest-leverage RAF improvement available within accurate coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E11.622 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Clearly document the anatomical location of the skin ulcer in the medical record
- •Differentiate from foot ulcers (E11.621) by confirming the ulcer location is non-pedal
Clinical Significance
Type 2 diabetes mellitus with other skin ulcer captures diabetic ulcers occurring at anatomical sites other than the foot, including the legs, sacrum, or other body areas. These ulcers reflect the systemic nature of diabetic vascular and healing impairment, where poor circulation and elevated glucose levels compromise tissue integrity and wound repair throughout the body. Non-pedal ulcers in diabetic patients may be equally challenging to manage.
Documentation Requirements
- ✓The medical record must document a skin ulcer at a non-foot location in a Type 2 diabetic patient, establishing the relationship to diabetes.
- ✓The anatomical site, ulcer dimensions, depth, presence of infection, and wound characteristics must be recorded.
- ✓Additional L97 or L98 codes should be assigned for site specificity.
- ✓Wound care treatment plans and progress documentation are essential.