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Type 2 diabetes mellitus without complications

E11.9 is a valid billable ICD-10 diagnosis code for Type 2 diabetes mellitus without complications. It is found in the 2020 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2019 - Sep 30, 2020.

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When using code E11.9 in processing claims, check the following: — See additional coding rules

  • Questionable admission codes - Some diagnoses are not usually sufficient justification for admission to an acute care hospital. For example, if a patient is given code R030 for elevated blood pressure reading, without diagnosis of hypertension, then the patient would have a questionable admission, since elevated blood pressure reading is not normally sufficient justification for admission to a hospital.

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  • Diabetes, diabetic (mellitus) (sugar)
MS-DRG - Medicare Severity-Diagnosis Related Group
  • Pre MDC
    Simultaneous Pancreas/Kidney Transplant
    • DRG 008 - SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT
  • Pre MDC
    Pancreas Transplant
  • MDC 10 Endocrine, Nutritional & Metabolic Diseases & Disorders
    Diabetes

Clinical Concepts

The code E11.9 can also be found in the following clinical concepts.

Coding structure:

ICD-10 code E11.9 is based on the following Tabular structure:

Chapter 4: Endocrine, nutritional and metabolic diseases
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Category
 
Etiology, Anatomic Site,
Severity, Other Vital Details
Extension

Should you use E11.9 or E119 (with or without decimal point)?
DO NOT include the decimal point when electronically filing claims as it may be rejected. Some clearinghouses may remove it for you but to avoid the 1 last update 01 Jun 2020 having a rejected claim due to an invalid ICD-10 code, do not include the decimal point when submitting claims electronically. Should you use E11.9 or E119 (with or without decimal point)?
DO NOT include the decimal point when electronically filing claims as it may be rejected. Some clearinghouses may remove it for you but to avoid having a rejected claim due to an invalid ICD-10 code, do not include the decimal point when submitting claims electronically.

See also:
  • Diabetes, diabetic (mellitus) (sugar) E11.9
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  1. E11 Type 2 diabetes mellitus

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    insulin (Z79.4)
    oral antidiabetic drugs (Z79.84)
    oral hypoglycemic drugs (Z79.84)

    Includes:

    • diabetes (mellitus) due to insulin secretory defect
    • diabetes NOS
    • insulin resistant diabetes (mellitus)

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    • diabetes mellitus due to underlying condition (E08.-)
    • drug or chemical induced diabetes mellitus (E09.-)
    • gestational diabetes (O24.4-)
    • neonatal diabetes mellitus (P70.2)
    • postpancreatectomy diabetes mellitus (E13.-)
    • postprocedural diabetes mellitus (E13.-)
    • secondary diabetes mellitus NEC (E13.-)
    • type 1 diabetes mellitus (E10.-)
    1. E11.0 Type 2 diabetes mellitus with hyperosmolarity

      1. E11.00 Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)

      2. E11.01 Type 2 diabetes mellitus with hyperosmolarity with coma

    2. E11.1 Type 2 diabetes mellitus with ketoacidosis

      1. E11.10 Type 2 diabetes mellitus with ketoacidosis without coma

      2. E11.11 Type 2 diabetes mellitus with ketoacidosis with coma

    3. E11.2 Type 2 diabetes mellitus with kidney complications

      1. E11.21 Type 2 diabetes mellitus with diabetic nephropathy

        Inclusion term(s):

        • Type 2 diabetes mellitus with intercapillary glomerulosclerosis
        • Type 2 diabetes mellitus with intracapillary glomerulonephrosis
        • Type 2 diabetes mellitus with Kimmelstiel-Wilson disease
      2. E11.22 Type 2 diabetes mellitus with diabetic chronic kidney disease

      3. E11.29 Type 2 diabetes mellitus with other diabetic kidney complication

        Inclusion term(s):

        • Type 2 diabetes mellitus with renal tubular degeneration
    4. E11.3 Type 2 diabetes mellitus with ophthalmic complications

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        • E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema
        • E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema
      2. E11.32 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy

        Inclusion for 1 last update 01 Jun 2020 term(s):Inclusion term(s):

        • Type 2 diabetes mellitus with nonproliferative diabetic retinopathy NOS
        • E11.321 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema
        • E11.329 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema
      3. E11.33 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy

        • E11.331 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
        • E11.339 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema
      4. E11.34 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy

        • E11.341 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema
        • E11.349 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema
      5. E11.35 Type 2 diabetes mellitus with proliferative diabetic retinopathy

        • E11.351 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema
        • E11.352 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula
        • E11.353 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula
        • E11.354 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
        • E11.355 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy
        • E11.359 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema
      6. E11.36 Type 2 diabetes mellitus with diabetic cataract

      7. E11.37 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment

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    5. E11.4 Type 2 diabetes mellitus with neurological complications

      1. E11.40 Type 2 diabetes mellitus with diabetic neuropathy, unspecified

      2. E11.41 Type 2 diabetes mellitus with diabetic mononeuropathy

      3. E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy

        Inclusion term(s):

        • Type 2 diabetes mellitus with diabetic neuralgia
      4. E11.43 Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy

        Inclusion term(s):

        • Type 2 diabetes mellitus with diabetic gastroparesis
      5. E11.44 Type 2 diabetes mellitus with diabetic amyotrophy

      6. E11.49 Type 2 diabetes mellitus with other diabetic neurological complication

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      1. E11.51 Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene

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        Inclusion term(s):

        • Type 2 diabetes mellitus with diabetic gangrene
      3. E11.59 Type 2 diabetes mellitus with other circulatory complications

    7. E11.6 Type 2 diabetes mellitus with other specified complications

      1. E11.61 Type 2 diabetes mellitus with diabetic arthropathy

        • E11.610 Type 2 diabetes mellitus with diabetic neuropathic arthropathy

          Inclusion term(s):

          • Type 2 diabetes mellitus with CharcΓ΄t's joints
        • E11.618 Type 2 diabetes mellitus with other diabetic arthropathy
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        • E11.620 Type 2 diabetes mellitus with diabetic dermatitis

          Inclusion term(s):

          • Type 2 diabetes mellitus with diabetic necrobiosis lipoidica
        • E11.621 Type 2 diabetes mellitus with foot ulcer
        • E11.622 Type 2 diabetes mellitus with other skin ulcer
        • E11.628 Type 2 diabetes mellitus with other skin complications
      3. E11.63 Type 2 diabetes mellitus with oral complications

        • E11.630 Type 2 diabetes mellitus with periodontal disease
        • E11.638 Type 2 diabetes mellitus with other oral complications
      4. E11.64 Type 2 diabetes mellitus with hypoglycemia

        • E11.641 Type 2 diabetes mellitus with hypoglycemia with coma
        • E11.649 Type 2 diabetes mellitus with hypoglycemia without coma
      5. E11.65 Type 2 diabetes mellitus with hyperglycemia

      6. E11.69 Type 2 diabetes mellitus with other specified complication

    8. E11.8 Type 2 diabetes mellitus with unspecified complications

    9. E11.9 Type 2 diabetes mellitus without complications

Abbreviations used here:

NEC Not elsewhere classifiable
This abbreviation in the Tabular List represents “other specified”. When a specific code is not available for a condition, the Tabular List includes an NEC entry under a code to identify the code as the “other specified” code.

NOS Not otherwise specified
This abbreviation is the equivalent of unspecified. NOS Not otherwise specified
This abbreviation is the equivalent of unspecified.

This note further define, or give examples of, the content of the code or category.

List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of “other specified” codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first, if applicable, followed by the manifestation. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.

A type 1 Excludes note is a pure excludes. It means 'NOT CODED HERE!' An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.

A type 2 Excludes note represents 'Not included here'. An Excludes2 note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When an Excludes2 note appears under a code it is acceptable to use both the code and the excluded code together.

A “code also” note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction. The sequencing depends on the circumstances of the encounter.

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first, if applicable, followed by the manifestation. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.

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