E13.8

HCC Category Mapping

What This Code Means

A type of diabetes mellitus (not type 1 or type 2) that has caused some complication, but the specific complication is not identified.

Coding Tips

• •Use this code only when the diabetes complication is documented but not specified; query the provider if possible to identify the specific complication for more accurate coding
• •This code requires a 5th character to indicate the type of complication; ensure complete code assignment

Clinical Significance

E13.8 represents other specified diabetes mellitus with unspecified complications, indicating that the provider has documented a diabetic complication but has not specified its nature. This code reflects a documentation gap and should trigger a query to the provider for additional detail to enable more specific code assignment.

Documentation Requirements

• ✓The provider must at minimum document secondary diabetes and the presence of a complication.
• ✓A query should be initiated to identify the specific complication type (renal, ophthalmic, neurological, vascular, etc.) and allow assignment of a more specific code within the E13 category.

Commonly Confused Codes