E13 ICD-10-CM Code: Other specified diabetes mellitus
E13 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
HCC Buddy Code Card
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Diabetes mellitus (E08-E13)
E13
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceOther specified diabetes mellitus
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for E13. Check the code and parent instructions in the Code Book.
Excludes 2
OfficialNo Excludes 2 notes are included in this display for E13. Check the code and parent instructions in the Code Book.
Related Codes
Includes
Official- diabetes mellitus due to genetic defects of beta-cell function
- diabetes mellitus due to genetic defects in insulin action
- postpancreatectomy diabetes mellitus
- postprocedural diabetes mellitus
- secondary diabetes mellitus NEC
Excludes 1
Official- diabetes (mellitus) due to autoimmune process (E10.-)
- diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)
- diabetes mellitus due to underlying condition (E08.-)
- drug or chemical induced diabetes mellitus (E09.-)
- gestational diabetes (O24.4-)
- neonatal diabetes mellitus (P70.2)
- type 1 diabetes mellitus (E10.-)
- transitory endocrine and metabolic disorders specific to newborn (P70-P74)Inherited from E00-E89
Code First
OfficialNo Code First sequencing instructions are included in this display for E13. Check the code and parent instructions in the Code Book.
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
OfficialNo Code Also instructions are included in this display for E13. Check the code and parent instructions in the Code Book.
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 →
- Code
- E13
- Description
- Other specified diabetes mellitus
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- No
- Payment year
- 2026
Coder workflow notes
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What This Code Means
E13 is the ICD-10-CM diagnosis code for other specified diabetes mellitus. E13 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering diabetes mellitus (e08-e13).
Header codes like E13 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for E13 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Includes
- diabetes mellitus due to genetic defects of beta-cell function
- diabetes mellitus due to genetic defects in insulin action
- postpancreatectomy diabetes mellitus
- postprocedural diabetes mellitus
- secondary diabetes mellitus NEC
Excludes 1, Do NOT code together
- diabetes (mellitus) due to autoimmune process (E10.-)
- diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)
- diabetes mellitus due to underlying condition (E08.-)
- drug or chemical induced diabetes mellitus (E09.-)
- gestational diabetes (O24.4-)
- neonatal diabetes mellitus (P70.2)
- type 1 diabetes mellitus (E10.-)