2026 ICD-10-CM Diagnosis Code E13.69Other specified diabetes mellitus with other specified complication

ICD-10-CM Codes›E00–E89›E08-E13›E13

ICD-10-CM E13.69
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

E13.69 is a billable ICD-10-CM diagnosis code for other specified diabetes mellitus with other specified complication. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 637 through 639. Coders also document this condition as diabetes mellitus associated with genetic syndrome. 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.

Code Identity

ICD-10-CM Code
E13.69
Billable Status
Yes — Valid for Submission
Code Describes
Other specified diabetes mellitus with other specified complication
Short Description
Oth diabetes mellitus with other specified complication
Parent Code
E13.6
Other specified diabetes mellitus with other specified complications

Code Classification

ChapterE00–E89Endocrine, nutritional and metabolic diseases
SectionE08-E13Diabetes mellitus
CategoryE13Other specified diabetes mellitus
This CodeE13.69Other specified diabetes mellitus with other specified complication

Quality Payment Program MeasuresBilling

Medicare quality measures that can apply when E13.69 is part of the patient record.

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

High Priority: YES

Measure Type: Intermediateoutcome

Submission Methods: Claims, Electronic Health Record, Cms Web Interface, Registry

Description: Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period.

View Measure

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Diabetes mellitus associated with genetic syndrome
  • Diabetes mellitus due to genetic defect in insulin action
  • Extreme insulin resistance with acanthosis nigricans, hirsutism AND abnormal insulin receptors
  • Hirsutism
  • Insulin receptor defect
  • Maternally inherited diabetes and deafness

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 2026, published by CMS and the National Center for Health Statistics.

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Use Additional Code

  • code to identify complication

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Diabetes, diabetic(mellitus) (sugar)
      • specified type NEC
        • with
          • complication
            • specified NEC

Clinical ClassificationClinical

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

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

Clinical InformationClinical

  • Hirsutism

    a condition observed in women and children when there is excess coarse body hair of an adult male distribution pattern, such as facial and chest areas. it is the result of elevated androgens from the ovaries, the adrenal glands, or exogenous sources. the concept does not include hypertrichosis, which is an androgen-independent excessive hair growth.

  • Androgen-dependent Hirsutism|Androgen-dependent hirsutism

    hirsutism that arises from an excess of male hormones.

  • Grade 1 Hirsutism, CTCAE|Grade 1 Hirsutism

    in women, increase in length, thickness or density of hair in a male distribution that the patient is able to camouflage by periodic shaving, bleaching, or removal of hair

  • Grade 2 Hirsutism, CTCAE|Grade 2 Hirsutism

    in women, increase in length, thickness or density of hair in a male distribution that requires daily shaving or consistent destructive means of hair removal to camouflage; associated with psychosocial impact

  • Hirsutism

    male-pattern hair growth on a female.

  • Hirsutism, CTCAE|Hirsutism|Hirsutism

    a disorder characterized by the presence of excess hair growth in women in anatomic sites where growth is considered to be a secondary male characteristic and under androgen control (beard, moustache, chest, abdomen).

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 E13.69 to ICD-9-CMHistory

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

ICD-9-CM
249.80 Sec DM oth nt st uncontr
Approximate The match is approximate rather than exact.
ICD-9-CM
250.80 DMII oth nt st uncntrld
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About E13.69Overview

Is E13.69 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report other specified diabetes mellitus with other specified complication on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does E13.69 group to?

When other specified diabetes mellitus with other specified complication is the principal diagnosis on an inpatient stay, it groups to MS-DRG 637, 638, 639, with relative weights from 0.6212 to 1.4367 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of E13.69?

Under the General Equivalence Mappings, other specified diabetes mellitus with other specified complication converts to ICD-9-CM 249.80 (sec DM oth nt st uncontr) and 250.80 (DMII oth nt st uncntrld). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.