E08-E13 — Diabetes mellitus
ICD-10-CM codes E08-E13 cover diabetes mellitus, within endocrine, nutritional and metabolic diseases. The block holds 582 codes across 5 categories, of which 432 are billable and 150 are header codes that cannot be submitted on a claim. 345 of them (59%) require a 7th character.
The 7th character in E08-E13
A code in this block is not complete without its 7th character, and a missing one is a rejected claim rather than a denied one: the clearinghouse never passes it on. 345 of the 582 codes here take one.
- 1
- right eye
- 2
- left eye
- 3
- bilateral
- 9
- unspecified eye
Risk adjustment in E08-E13
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 37 Diabetes with Chronic Complications
- HCC 298 Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage
- HCC 36 Diabetes with Severe Acute Complications
- HCC 38 Diabetes with No, Glycemic, or Unspecified Complications
- HCC 383 Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle
- HCC 263 Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene
What else to watch in E08-E13
- 432 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.