2027 ICD-10-CM Diagnosis Code E09.36Drug or chemical induced diabetes mellitus with diabetic cataract

ICD-10-CM Codes›E00–E89›E08-E13›E09

ICD-10-CM E09.36
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

E09.36 is a billable ICD-10-CM diagnosis code for drug or chemical induced diabetes mellitus with diabetic cataract. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 8, 10, 19, 124 through 125. Coders also document this condition as cataract due to diabetes mellitus. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cataract and other lens disorders; Diabetes mellitus with complication; and Diabetes mellitus, due to underlying condition, drug or chemical induced, or other specified type.

E09.36 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 18 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 18, ESRD (V21) category 18, ESRD (V24) category 18, and RxHCC Part D (V08) category 30 for payment year 2027.

Code Identity

ICD-10-CM Code
E09.36
Billable Status
Yes — Valid for Submission
Code Describes
Drug or chemical induced diabetes mellitus with diabetic cataract
Short Description
Drug/chem diabetes mellitus w diabetic cataract
Parent Code
Drug or chemical induced diabetes mellitus with ophthalmic complications

Code Classification

ChapterE00–E89Endocrine, nutritional and metabolic diseases
SectionE08-E13Diabetes mellitus
CategoryE09Drug or chemical induced diabetes mellitus
This CodeE09.36Drug or chemical induced diabetes mellitus with diabetic cataract

Medicare Risk Adjustment (HCC)Billing

E09.36 no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
Dropped in V28 see all codes that no longer risk-adjust
Prior Model (CMS-HCC V24)
HCC 18
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 18 · ESRD (V21): HCC 18 · ESRD (V24): HCC 18
ESRD V21 weights: 0.091 dialysis, 0.243–0.373 functioning graft · ESRD V24 weights: 0.084 dialysis, 0.219–0.359 functioning graft
Part D (RxHCC)
RxHCC 30 — Diabetes with Complications
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Cataract due to diabetes mellitus
  • Cataract due to drug induced diabetes mellitus
  • Disorder of vision due to secondary diabetes mellitus

Coding GuidelinesGuidance

The diabetes mellitus codes are combination codes that include the type of diabetes mellitus, the body system affected, and the complications affecting that body system. As many codes within a particular category as are necessary to describe all of the complications of the disease may be used. They should be sequenced based on the reason for a particular encounter. Assign as many codes from categories E08 - E13 as needed to identify all of the associated conditions that the patient has.

Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to E09.36: its own notes plus those printed at E09 and Chapter 4. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From E09 Drug or chemical induced diabetes mellitus applies to 86 codes
  • diabetes mellitus due to underlying condition (E08.-)
  • 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.-)
  • type 2 diabetes mellitus (E11.-)
From Chapter 4 (E00-E89) Endocrine, nutritional and metabolic diseases applies to 973 codes
  • transitory endocrine and metabolic disorders specific to newborn (P70-P74)

Code First

The underlying condition named in the note is sequenced before this code.

From E09 Drug or chemical induced diabetes mellitus applies to 86 codes
  • poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From E09 Drug or chemical induced diabetes mellitus applies to 86 codes
  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • code to identify control using:
  • injectable non-insulin antidiabetic drugs (Z79.85)
  • insulin (Z79.4)
  • oral antidiabetic drugs (Z79.84)
  • oral hypoglycemic drugs (Z79.84)

Notes

General instructions on how these codes are used.

From Chapter 4 (E00-E89) Endocrine, nutritional and metabolic diseases applies to 973 codes
  • All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name E09.36, its category, or a range that includes it.

Excludes1 6

These codes carry an Excludes1 note naming E09.36: they are not reported together with it, unless the two conditions are unrelated.

  • H28 Cataract in diseases classified elsewhere
    cataract in diabetes mellitus (E08.36, E09.36, E10.36, E11.36, E13.36)
  • E08 Diabetes mellitus due to underlying condition
    drug or chemical induced diabetes mellitus (E09.-) names E09.-, which includes this code
  • E10 Type 1 diabetes mellitus
    drug or chemical induced diabetes mellitus (E09.-) names E09.-, which includes this code
  • E11 Type 2 diabetes mellitus
    drug or chemical induced diabetes mellitus (E09.-) names E09.-, which includes this code
  • E13 Other specified diabetes mellitus
    drug or chemical induced diabetes mellitus (E09.-) names E09.-, which includes this code
  • H36 Retinal disorders in diseases classified elsewhere
    diabetic retinopathy (E08.3-, E09.3-, E10.3-, E11.3-, E13.3-) names E09.3-, which includes this code

Excludes2 2

These codes carry an Excludes2 note naming E09.36: its condition is not part of those codes, and both may be reported when the patient has both.

  • E87.0 Hyperosmolality and hypernatremia
    diabetes with hyperosmolarity (E08, E09, E11, E13 with final characters .00 or .01) names E09, which includes this code
  • Chapter 7 (H00-H59) Diseases of the eye and adnexa
    diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-) names E09.3-, which includes this code

Use Additional Code 2

These codes say to use an additional code from the note, and E09.36 is one of the codes named.

  • O24.8 Other pre-existing diabetes mellitus in pregnancy, childbirth, and the puerperium
    from categories E08, E09 and E13 to further identify any manifestation names E09, which includes this code
  • O24.9 Unspecified diabetes mellitus in pregnancy, childbirth and the puerperium
    from categories E08, E09 and E13 to further identify any manifestation names E09, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR EYE002
Cataract and other lens disorders
Default principal diagnosis: inpatient No · outpatient No
CCSR END003
Diabetes mellitus with complication
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR END006
Diabetes mellitus, due to underlying condition, drug or chemical induced, or other specified type
Default principal diagnosis: inpatient No · outpatient No

Patient EducationClinical

Cataract

A cataract is a clouding of the clear lens inside your eye. This cloudiness blocks light from reaching the back of the eye, making it harder to see clearly. A cataract can affect one or both eyes, but it doesn't spread from one eye to the other.

The full article covers:

  • What are cataracts?
  • What causes cataracts?
  • Who is more likely to develop cataracts?
  • What are the symptoms of cataracts?
  • How are cataracts diagnosed?
  • How are cataracts treated?
  • Can cataracts be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert E09.36 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
249.50 Sec DM ophth nt st uncn
Approximate The match is approximate rather than exact.
ICD-9-CM
249.50 Sec DM ophth nt st uncn
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.
ICD-9-CM
366.41 Diabetic cataract
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About E09.36Overview

What is the ICD-10 code for drug or chemical induced diabetes mellitus with diabetic cataract?

The ICD-10-CM code for drug or chemical induced diabetes mellitus with diabetic cataract is E09.36 (sometimes written as E0936). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is E09.36 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report drug or chemical induced diabetes mellitus with diabetic cataract on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does E09.36 group to?

When drug or chemical induced diabetes mellitus with diabetic cataract is the principal diagnosis on an inpatient stay, it groups to MS-DRG 125, 8, 10, 19, 124, with relative weights from 0.7699 to 7.5461 depending on complications. Higher weights mean higher Medicare reimbursement.

Can E09.36 be reported with a code from E08?

Not as a rule. The Excludes1 note at E09, which applies to E09.36, lists "diabetes mellitus due to underlying condition (E08.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

Does E09.36 need an additional code?

When the condition applies, yes. The Use Additional Code note at E09, which applies to E09.36, reads: code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5); code to identify control using:; injectable non-insulin antidiabetic drugs (Z79.85); insulin (Z79.4); oral antidiabetic drugs (Z79.84); and 1 more listed in the Instructional Notes section. The additional code is reported after E09.36.

Does E09.36 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. E09.36 mapped to HCC 18 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 18 (Diabetes with Chronic Complications), ESRD (V21) category 18 (Diabetes with Chronic Complications), ESRD (V24) category 18 (Diabetes with Chronic Complications), and RxHCC Part D (V08) category 30 (Diabetes with Complications).