Is E13.69 a billable ICD-10-CM code?

Yes. E13.69 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does E13.69 sit in the tabular list?

Endocrine, nutritional and metabolic diseases (E00-E89), in the block Diabetes mellitus (E08-E13).

What cannot be coded together with E13.69?

E13.69 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above E13.69 (E13) and apply to it just the same.

E13.69

E13.69 — Other specified diabetes mellitus with other specified complication

Billable / specific codeICD-10-CM

E13.69 is a billable, specific ICD-10-CM code for other specified diabetes mellitus with other specified complication. It is valid for submission on a claim.

Use additional code

Add a secondary code to capture the detail described below.

code to identify complication

Excludes1 inherited from the categories above E13.69

These are not written on E13.69, but they bind it: a note on a category applies to every code beneath it. Billing E13.69 with anything listed here is a denial.

Written on E13 — Other specified diabetes mellitus

diabetes (mellitus) due to autoimmune process (E10.-)
diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)
diabetes mellitus due to underlying condition (E08.-)
drug or chemical induced diabetes mellitus (E09.-)
gestational diabetes (O24.4-)
neonatal diabetes mellitus (P70.2)
type 1 diabetes mellitus (E10.-)

Other codes that can never be billed with E13.69

These codes carry an Excludes1 note pointing at E13.69. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading E13.69 alone.

E10Type 1 diabetes mellitus
E11Type 2 diabetes mellitus
E09Drug or chemical induced diabetes mellitus
E08Diabetes mellitus due to underlying condition

Risk adjustment

E13.69 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.

Medicare coverage

E13.69 is named in 27 Medicare coverage policies — 27 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

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

How E13.69 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to E13.69.

Diabetes, diabetic›specified type NEC›with›complication›specified NEC

Code history

E13.69 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share E13.6. If E13.69 is not quite right, the correct code is usually one of these.

Questions about E13.69

Is E13.69 a billable ICD-10-CM code?: Yes. E13.69 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does E13.69 sit in the tabular list?: Endocrine, nutritional and metabolic diseases (E00-E89), in the block Diabetes mellitus (E08-E13).
What cannot be coded together with E13.69?: E13.69 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above E13.69 (E13) and apply to it just the same.