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FY2027 ICD-10-CM reference

E13.622: Other specified diabetes mellitus with other skin ulcer

By the HCC Buddy Coding Team

The official ICD-10-CM descriptor is Other specified diabetes mellitus with other skin ulcer. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Billable code. Verified against the official FY2027 order file.

CMS-HCC V28

  • HCC 37: Diabetes with Chronic Complications · RAF 0.166, Community Non-Dual Aged (CNA)
  • HCC 383: Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle · RAF 0.646, Community Non-Dual Aged (CNA)

Payment year 2027, 2026 dates of service. HCC from the CMS 2027 Initial ICD-10-CM Mappings; RAF from the CMS-HCC V28 relative factors. For 2027 dates of service, CMS has not yet published the payment year 2028 mappings.

CMS-HCC V24

Not used for payment year 2027 Medicare Advantage payment

ESRD

  • HCC 18: Diabetes with Chronic Complications
  • HCC 161: Chronic Ulcer of Skin/Except Pressure

Coefficient pending: payment year 2027 coefficients for this model are not yet verified, so no RAF is shown. Mapping: PY2026 CMS mapping; CMS 2027 initial file unchanged.

PACE

Source verification pending

RxHCC

  • HCC 30: Diabetes with Complications
  • HCC 311: Chronic Ulcer of Skin, Except Pressure

Coefficient pending: payment year 2027 coefficients for this model are not yet verified, so no RAF is shown. Mapping: PY2026 CMS mapping; CMS 2027 initial file unchanged.

HHS-HCC

  • HCC 20: Diabetes with Chronic Complications

RAF not applicable: HHS-HCC weights vary by metal level. Mapping: HHS-HCC 2026 benefit year.

FY2027 Tabular instructions

Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.

Instructional note

All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.

Source: E00-E89 (chapter, inherited).

Excludes1

transitory endocrine and metabolic disorders specific to newborn (P70-P74)

Source: E00-E89 (chapter, inherited).

Includes

diabetes mellitus due to genetic defects of beta-cell function

Source: E13 (category, inherited).

Includes

diabetes mellitus due to genetic defects in insulin action

Source: E13 (category, inherited).

Includes

postpancreatectomy diabetes mellitus

Source: E13 (category, inherited).

Includes

postprocedural diabetes mellitus

Source: E13 (category, inherited).

Includes

secondary diabetes mellitus NEC

Source: E13 (category, inherited).

Instructional note

code to identify control using:

Source: E13 (category, inherited).

Instructional note

injectable non-insulin antidiabetic drugs (Z79.85)

Source: E13 (category, inherited).

Instructional note

insulin (Z79.4)

Source: E13 (category, inherited).

Instructional note

oral antidiabetic drugs (Z79.84)

Source: E13 (category, inherited).

Instructional note

oral hypoglycemic drugs (Z79.84)

Source: E13 (category, inherited).

Excludes1

diabetes (mellitus) due to autoimmune process (E10.-)

Source: E13 (category, inherited).

Excludes1

diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)

Source: E13 (category, inherited).

Excludes1

diabetes mellitus due to underlying condition (E08.-)

Source: E13 (category, inherited).

Excludes1

drug or chemical induced diabetes mellitus (E09.-)

Source: E13 (category, inherited).

Excludes1

gestational diabetes (O24.4-)

Source: E13 (category, inherited).

Excludes1

neonatal diabetes mellitus (P70.2)

Source: E13 (category, inherited).

Excludes1

type 1 diabetes mellitus (E10.-)

Source: E13 (category, inherited).

Instructional note

code to identify site of ulcer (L97.1-L97.9, L98.41-L98.49)

Source: E13.622 (self, direct).

Source: CMS FY2027 Tabular List and Alphabetic Index.

Open Tabular instructions and code details

Compare the FY2027 additions, removals and billable-status changes

What does E13.622 mean in FY2027?

The official ICD-10-CM descriptor is Other specified diabetes mellitus with other skin ulcer. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Is E13.622 billable in FY2027?

The FY2027 order file marks E13.622 as billable. Check the complete Tabular instructions and documentation before assigning it.

Does E13.622 map to an HCC?

In the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service), E13.622 maps to CMS-HCC V28 HCC 37 (Diabetes with Chronic Complications) and HCC 383 (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle). For 2027 dates of service, CMS has not yet published the payment year 2028 mappings. Under the PY2026 CMS mapping; CMS 2027 initial file unchanged: ESRD HCC 18 and HCC 161; RxHCC HCC 30 and HCC 311. Coefficients for these models are pending verification for payment year 2027. HHS-HCC: HCC 20 under the HHS-HCC 2026 benefit year mapping (no RAF; HHS-HCC weights vary by metal level). CMS-HCC V24: not used for payment year 2027 Medicare Advantage payment (CMS CY 2027 Rate Announcement). The PACE mapping is still pending verification for FY2027.

Source: CMS FY2027 ICD-10-CM order file. Payment model: CMS CY 2027 Rate Announcement. Read the FY2027 Official Guidelines.

Review the FY2026 April edition