Question 1

What is ICD-10 code E13.622?

Accepted Answer

E13.622 is the ICD-10-CM diagnosis code for Other specified diabetes mellitus with other skin ulcer. A type of diabetes (not type 1 or type 2) that causes an open sore or ulcer on the skin in areas other than the foot. E13.622 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E13.622 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.

Question 2

Is E13.622 an HCC code?

Accepted Answer

No. E13.622 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is E13.622 billable?

Accepted Answer

Yes. E13.622 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. E13.622 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.

Question 4

What is the V28 vs V24 difference for E13.622?

Accepted Answer

E13.622 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 E13.622 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.

Question 5

What should coders know when reporting E13.622?

Accepted Answer

Specify the anatomical location of the skin ulcer in documentation Use additional L97 or L98 codes to identify the specific site and severity of the ulcer

E13.622

Is E13.622 an HCC code?

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Open E13.622 in the Interactive Encoder