E13.621
BillableOther specified diabetes mellitus with foot ulcer
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E13.621 an HCC code?
No. E13.621 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
E13.621 is the ICD-10-CM diagnosis code for other specified diabetes mellitus with foot ulcer. A type of diabetes (not type 1 or type 2) that causes an open sore or ulcer on the foot. E13.621 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering diabetes mellitus (e08-e13).
E13.621 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. However, the L97 codes used additionally may capture separate HCC value. The clinical significance and resource utilization of diabetic foot ulcers make thorough documentation essential regardless of direct HCC mapping.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E13.621 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always specify the location and severity of the foot ulcer; additional codes (L97 series) may be required
- •Document whether the ulcer is infected and the stage/depth of the ulcer
Clinical Significance
E13.621 identifies diabetic foot ulcer in other specified diabetes mellitus, one of the most clinically significant complications of diabetes. Diabetic foot ulcers result from the combination of neuropathy, peripheral vascular disease, and impaired immune function, and are a leading cause of non-traumatic lower extremity amputations. They require intensive wound management and multidisciplinary care.
Documentation Requirements
- ✓Documentation must confirm secondary diabetes, the foot ulcer location (specify which foot and anatomic site), and the relationship to diabetes.
- ✓Wound characteristics including size, depth, presence of infection, and Wagner or University of Texas wound classification should be documented.
- ✓Additional codes for laterality and ulcer severity (L97.x) are required.