E10.21

E10.21: Type 1 diabetes mellitus with diabetic nephropathy

Billable / specific codeICD-10-CM

E10.21 is a billable, specific ICD-10-CM code for type 1 diabetes mellitus with diabetic nephropathy. It is valid for submission on a claim.

Check E10.21 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Type 1 diabetes mellitus with intercapillary glomerulosclerosis
Type 1 diabetes mellitus with intracapillary glomerulonephrosis
Type 1 diabetes mellitus with Kimmelstiel-Wilson disease

Excludes1 inherited from the categories above E10.21

A category’s note binds every code beneath it.

Written on E10: Type 1 diabetes mellitus

diabetes mellitus due to underlying condition (E08.-)
drug or chemical induced diabetes mellitus (E09.-)
gestational diabetes (O24.4-)
hyperglycemia NOS (R73.9)
neonatal diabetes mellitus (P70.2)
postpancreatectomy diabetes mellitus (E13.-)
postprocedural diabetes mellitus (E13.-)
secondary diabetes mellitus NEC (E13.-)
type 2 diabetes mellitus (E11.-)

Other codes that can never be billed with E10.21

Their own Excludes1 notes name this code, so the conflict is not listed above.

E08Diabetes mellitus due to underlying condition
E09Drug or chemical induced diabetes mellitus
E11Type 2 diabetes mellitus
E13Other specified diabetes mellitus
Q45.3Other congenital malformations of pancreas and pancreatic duct

Risk adjustment

E10.21 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:

HCC 37 Diabetes with Chronic Complications0.166 RAF
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

E10.21 is named in 28 Medicare coverage policies: 28 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52464Glucose Monitor - Policy Article
A52501Therapeutic Shoes for Persons with Diabetes - Policy Article
A52507External Infusion Pumps - Policy Article
A52996Billing and Coding: Routine Foot Care

Alphabetic index entries that lead here

Diabetes, diabetic›type 1›with›glomerulonephrosis, intracapillary
Diabetes, diabetic›type 1›with›glomerulosclerosis, intercapillary
Diabetes, diabetic›type 1›with›Kimmelstiel-Wilson disease
Diabetes, diabetic›type 1›with›nephropathy

Code history

Unchanged in every release from FY2024 to FY2027.