E08.43: Diabetes mellitus due to underlying condition with diabetic autonomic (poly)neuropathy

Risk adjustment

E08.43 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

• HCC 37 Diabetes with Chronic Complications0.166 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

E08.43 is named in 37 Medicare coverage policies: 34 listing it as supporting medical necessity, and 3 listing it as NOT covered. Which one applies depends on your Medicare contractor.

• A56731Billing and Coding: Nerve Blocks and Electrostimulation for Peripheral Neuropathynot covered
• A57589Billing and Coding: Nerve Blocks for Peripheral Neuropathynot covered
• A57663Billing and Coding: Nerve Blocks for Peripheral Neuropathynot covered
• A52464Glucose Monitor - Policy Article