2027 ICD-10-CM Diagnosis Code E09.69Drug or chemical induced diabetes mellitus with other specified complication
ICD-10-CM Codes›E00–E89›E08-E13›E09
- Billable — Valid for Submission
- Chronic Condition
E09.69 is a billable ICD-10-CM diagnosis code for drug or chemical induced diabetes mellitus with other specified complication. 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, 637 through 639. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Diabetes mellitus with complication; and Diabetes mellitus, due to underlying condition, drug or chemical induced, or other specified type.
E09.69 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
Code Classification
Medicare Risk Adjustment (HCC)Billing
E09.69 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.
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.
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 E09.69: 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.
- 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.-)
Code First
The underlying condition named in the note is sequenced before this code.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify complication
Notes
General instructions on how these codes are used.
- 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 E09.69, its category, or a range that includes it.
Excludes1 4
These codes carry an Excludes1 note naming E09.69: they are not reported together with it, unless the two conditions are unrelated.
- E08 Diabetes mellitus due to underlying conditiondrug or chemical induced diabetes mellitus (E09.-) names E09.-, which includes this code
- E10 Type 1 diabetes mellitusdrug or chemical induced diabetes mellitus (E09.-) names E09.-, which includes this code
- E11 Type 2 diabetes mellitusdrug or chemical induced diabetes mellitus (E09.-) names E09.-, which includes this code
- E13 Other specified diabetes mellitusdrug or chemical induced diabetes mellitus (E09.-) names E09.-, which includes this code
Excludes2 1
These codes carry an Excludes2 note naming E09.69: its condition is not part of those codes, and both may be reported when the patient has both.
Use Additional Code 2
These codes say to use an additional code from the note, and E09.69 is one of the codes named.
- O24.8 Other pre-existing diabetes mellitus in pregnancy, childbirth, and the puerperiumfrom 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 puerperiumfrom 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.
Patient EducationClinical
Diabetes
Diabetes, also known as diabetes mellitus, is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your body's main source of energy. Your body can make glucose, but it also comes from the food you eat. Insulin is a hormone made by your pancreas.
The full article covers:
- What is diabetes?
- What are the types of diabetes?
- What causes diabetes?
- Who is more likely to develop diabetes?
- What are the symptoms of diabetes?
- How is diabetes diagnosed?
- What are the treatments for diabetes?
- Can diabetes be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert E09.69 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About E09.69Overview
Is E09.69 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report drug or chemical induced diabetes mellitus with other specified complication on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does E09.69 group to?
When drug or chemical induced diabetes mellitus with other specified complication is the principal diagnosis on an inpatient stay, it groups to MS-DRG 638, 639, 8, 10, 637, 19, with relative weights from 0.6375 to 7.5461 depending on complications. Higher weights mean higher Medicare reimbursement.
Can E09.69 be reported with a code from E08?
Not as a rule. The Excludes1 note at E09, which applies to E09.69, 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 E09.69 need an additional code?
When the condition applies, yes. The Use Additional Code note reads: code to identify complication. The additional code is reported after E09.69.
What is the ICD-9 equivalent of E09.69?
Under the General Equivalence Mappings, drug or chemical induced diabetes mellitus with other specified complication converts to ICD-9-CM 249.80 (sec DM oth nt st uncontr). The mapping is approximate, so confirm the match fits the documentation.
Does E09.69 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage. E09.69 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).
