E15 ICD-10-CM Code: Nondiabetic hypoglycemic coma
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Other disorders of glucose regulation and pancreatic internal secretion (E15-E16)
E15
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceNondiabetic hypoglycemic coma
This is a serious condition where a person loses consciousness due to dangerously low blood sugar levels, but they do not have diabetes. This can occur from certain medications, liver disease, or other medical conditions that affect how the body regulates blood sugar.
Buddy Insight
E15 identifies nondiabetic hypoglycemic coma, a medical emergency where critically low blood glucose causes loss of consciousness in a patient without diabetes mellitus.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
MappedHCC 23
RAF 0.194
ACA/HHS
MappedHCC 30
Varies by metal level
ESRD/PACE
MappedHCC 23
RAF 0.036
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for E15 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for E15 in this effective period.
Related Child Codes
ICD-10-CM does not list child codes under E15 for this display context.
Includes
Official- drug-induced insulin coma in nondiabetic
- hyperinsulinism with hypoglycemic coma
- hypoglycemic coma NOS
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for E15 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for E15 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for E15 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for E15 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is E15 an HCC code?
Yes. E15 maps to Other Significant Endocrine and Metabolic Disorders under the V24 model but is not retained in V28.
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
Work E15 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for E15
For E15to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed E15 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
E15 is the ICD-10-CM diagnosis code for nondiabetic hypoglycemic coma. This is a serious condition where a person loses consciousness due to dangerously low blood sugar levels, but they do not have diabetes. This can occur from certain medications, liver disease, or other medical conditions that affect how the body regulates blood sugar. E15 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering other disorders of glucose regulation and pancreatic internal secretion (e15-e16).
Under the older CMS-HCC V24 model, E15 maps to Other Significant Endocrine and Metabolic Disorders (HCC 23) with a community, non-dual, aged base RAF weight of 0.194. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Verify the patient does not have diabetes before coding E15; if diabetic hypoglycemia is present, use E10-E13 codes instead with the appropriate hypoglycemia manifestation code. Because E15 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E15 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the patient does not have diabetes before coding E15; if diabetic hypoglycemia is present, use E10-E13 codes instead with the appropriate hypoglycemia manifestation code
- •Document the underlying cause of hypoglycemia (such as medication-induced, liver disease, or insulinoma) as this may require additional coding and helps establish medical necessity
Clinical Significance
E15 identifies nondiabetic hypoglycemic coma, a medical emergency where critically low blood glucose causes loss of consciousness in a patient without diabetes mellitus. Causes include insulinoma, exogenous insulin administration (factitious or iatrogenic), severe hepatic failure, adrenal insufficiency, sepsis, or alcohol intoxication with depleted glycogen stores.
Documentation Requirements
- ✓Documentation must confirm hypoglycemic coma and the absence of diabetes mellitus.
- ✓The underlying cause of the hypoglycemia should be identified and documented.
- ✓Blood glucose levels, treatment administered, and clinical response should be recorded.
Includes
- drug-induced insulin coma in nondiabetic
- hyperinsulinism with hypoglycemic coma
- hypoglycemic coma NOS