E11.8 ICD-10-CM Code: Type 2 diabetes mellitus with unspecified complications
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Diabetes mellitus (E08-E13)
E11.8
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceType 2 diabetes mellitus with unspecified complications
Type 2 diabetes with complications that are not specifically identified or classified elsewhere.
Buddy Insight
E11.
CMS-HCC V28
MappedHCC 38
RAF 0.450
CMS-HCC V24
MappedHCC 18
RAF 0.302
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 18
RAF 0.0
RXHCC
MappedHCC 30
RAF 0.0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for E11.8 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E11.8 in this effective period.
Related Child Codes
Includes
Official- diabetes (mellitus) due to insulin secretory defect
- diabetes NOS
- insulin resistant diabetes (mellitus)
Excludes 1
Official- diabetes mellitus due to underlying condition (E08.-)
- drug or chemical induced diabetes mellitus (E09.-)
- gestational diabetes (O24.4-)
- neonatal diabetes mellitus (P70.2)
- postpancreatectomy diabetes mellitus (E13.-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E11.8 in this effective period.
Use Additional
Official- code to identify control using:
- injectable non-insulin antidiabetic drugs (Z79.85)
- insulin (Z79.4)
- oral antidiabetic drugs (Z79.84)
- oral hypoglycemic drugs (Z79.84)
Code Also
OfficialICD-10-CM does not list Code Also instructions for E11.8 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 E11.8 an HCC code?
Yes. E11.8 maps to Diabetes without Complication under the CMS-HCC V28 risk adjustment model (and Diabetes with Chronic Complications under V24).
HCC Category Mapping
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 E11.8
For E11.8to 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 E11.8 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
E11.8 is the ICD-10-CM diagnosis code for type 2 diabetes mellitus with unspecified complications. Type 2 diabetes with complications that are not specifically identified or classified elsewhere. E11.8 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, E11.8 maps to Diabetes without Complication (HCC 38) with a community, non-dual, aged base RAF weight of 0.450. Under the older CMS-HCC V24 model, E11.8 maps to Diabetes with Chronic Complications (HCC 18) with a community, non-dual, aged base RAF weight of 0.302. 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.
Use this code only when the complication cannot be assigned to a more specific E11 code. Because E11.8 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 E11.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the complication cannot be assigned to a more specific E11 code
- •Document the nature of the complication clearly to support medical necessity and allow for future specificity
Clinical Significance
E11.8 represents type 2 diabetes mellitus with complications that are present but not further specified in the clinical documentation. This code signals that the patient's diabetes is not uncomplicated, yet the exact nature of the complication has not been identified or documented to the level of specificity available in the ICD-10-CM classification.
Documentation Requirements
- ✓Providers should be queried to specify the nature of the diabetic complication whenever possible, as this code reflects a lack of documentation specificity.
- ✓The record should at minimum state that a diabetes-related complication exists, even if it cannot be further classified.