What is ICD-10 code E13.52?

E13.52 is the ICD-10-CM diagnosis code for Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene. A type of diabetes (not type 1 or type 2) causing poor blood circulation in the legs and feet that has resulted in tissue death or gangrene. E13.52 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E13.52 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. E13.52 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. E13.52 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 E13.52?

E13.52 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards E13.52 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

What should coders know when reporting E13.52?

Confirm gangrene is documented; this is a more severe condition than E13.51 Document the extent and location of gangrene for treatment planning

E13.52 ICD-10 Code: Other specified diabetes

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupE13.52Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

E13.52

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

Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene

A type of diabetes (not type 1 or type 2) causing poor blood circulation in the legs and feet that has resulted in tissue death or gangrene.

Buddy Insight

E13.

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

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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Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

E13Other specified diabetes mellitus

E13.5Other specified diabetes mellitus with circulatory complications

E13.52Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene

Inclusion Terms

Official

Other specified diabetes mellitus with diabetic gangrene

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E13.52 in this effective period.

Related Child Codes

Official

E13.51Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene

E13.59Other specified diabetes mellitus with other circulatory complications

Includes

Official

ICD-10-CM does not list Includes notes for E13.52 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for E13.52 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E13.52 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for E13.52 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for E13.52 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation must confirm secondary diabetes, peripheral vascular disease with gangrene, and the diabetic etiology.

The location and extent of gangrene must be specified.

Wound care documentation, vascular surgery notes, and amputation records if applicable should be present.

MEAT Support

HCC Buddy guidance

Documentation must confirm secondary diabetes, peripheral vascular disease with gangrene, and the diabetic etiology.

The location and extent of gangrene must be specified.

Wound care documentation, vascular surgery notes, and amputation records if applicable should be present.

Audit Caution

HCC Buddy guidance

Gangrene must be explicitly documented in the record

do not infer gangrene from wound descriptions. Code the specific type of gangrene (dry, wet, gas) and site if documented. Additional codes for the gangrene site and any surgical procedures should be assigned.

Common Mistakes

HCC Buddy guidance

E13.51 (peripheral angiopathy without gangrene) when tissue necrosis has not developed

I96 (gangrene not elsewhere classified) when gangrene is not attributed to diabetes

E11.52 (type 2 diabetes with peripheral angiopathy with gangrene) when diabetes is type 2.

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 E13.52 an HCC code?

No. E13.52 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

HCC Category Mapping

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 E13.52

For E13.52to 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 E13.52 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

E13.52 is the ICD-10-CM diagnosis code for other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene. A type of diabetes (not type 1 or type 2) causing poor blood circulation in the legs and feet that has resulted in tissue death or gangrene. E13.52 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering diabetes mellitus (e08-e13).

E13.52 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.

This code has no V28 or V24 HCC mapping in the provided data, which may reflect model-specific exclusions or payment bundling. However, the clinical severity warrants thorough documentation for any applicable supplemental risk models or quality metrics. Coders reviewing E13.52 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-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E13.52 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Confirm gangrene is documented; this is a more severe condition than E13.51
•Document the extent and location of gangrene for treatment planning

Clinical Significance

E13.52 represents the most severe vascular complication of other specified diabetes mellitus, with peripheral angiopathy progressing to gangrene. Diabetic gangrene indicates tissue death due to inadequate blood supply and often requires surgical intervention including debridement or amputation. This condition carries significant morbidity, mortality, and resource utilization.

Documentation Requirements

✓Documentation must confirm secondary diabetes, peripheral vascular disease with gangrene, and the diabetic etiology.
✓The location and extent of gangrene must be specified.
✓Wound care documentation, vascular surgery notes, and amputation records if applicable should be present.

Commonly Confused Codes

•E13.51 (peripheral angiopathy without gangrene) when tissue necrosis has not developed
•I96 (gangrene not elsewhere classified) when gangrene is not attributed to diabetes
•E11.52 (type 2 diabetes with peripheral angiopathy with gangrene) when diabetes is type 2.