FY2027 ICD-10-CM reference
E13.9: Other specified diabetes mellitus without complications
By the HCC Buddy Coding Team
The official ICD-10-CM descriptor is Other specified diabetes mellitus without complications. 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 38: Diabetes with No, Glycemic, or Unspecified Complications · RAF 0.166, 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 19: Diabetes without Complication
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 31: Diabetes without Complication
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 21: Diabetes without Complication
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).
Compare the FY2027 additions, removals and billable-status changes
What does E13.9 mean in FY2027?
The official ICD-10-CM descriptor is Other specified diabetes mellitus without complications. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Is E13.9 billable in FY2027?
The FY2027 order file marks E13.9 as billable. Check the complete Tabular instructions and documentation before assigning it.
Does E13.9 map to an HCC?
In the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service), E13.9 maps to CMS-HCC V28 HCC 38 (Diabetes with No, Glycemic, or Unspecified Complications). 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 19; RxHCC HCC 31. Coefficients for these models are pending verification for payment year 2027. HHS-HCC: HCC 21 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