E13.9

Billable

Other specified diabetes mellitus without complications

HCC Category Mapping

V28HCC 38 — Diabetes without Complication

0.450

V24HCC 19 — Diabetes without Complication

0.105

ESRDHCC 19 — Diabetes without Complication

0.000

RxHCCHCC 31 — Diabetes without Complication

0.000

What This Code Means

A type of diabetes mellitus (not type 1 or type 2) without any documented complications.

Coding Tips

•This is the default code when other specified diabetes is present without complications; verify documentation does not mention any diabetic complications
•Do not use this code if any complications are documented; select the appropriate E13.8x code instead

Clinical Significance

E13.9 identifies other specified diabetes mellitus without any documented complications. This code captures secondary diabetes (due to conditions such as pancreatitis, cystic fibrosis, hemochromatosis, or drug-induced causes) that is currently managed without evidence of end-organ damage or acute metabolic decompensation.

Documentation Requirements

✓The provider must document the diagnosis of other specified/secondary diabetes and its underlying cause.
✓The record should clearly identify the etiology of the secondary diabetes.
✓If any complications exist but are undocumented, the coder should query the provider for completeness.

Commonly Confused Codes

E11.9 (type 2 diabetes without complications) when the diabetes is type 2 E13.8 (unspecified complications) when complications exist but are not characterized E08.9 or E09.9 (diabetes due to underlying condition or drug-induced) which may be more appropriate depending on the etiology.

Code Hierarchy

└E13Other specified diabetes mellitus └E13.9Other specified diabetes mellitus without complications

└E13.9Other specified diabetes mellitus without complications