Name: Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy
Creator: MedCoder.ai

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives: 4 inclusion terms · 8 Excludes1 · 5 use-additional codes
Risk adjustment: CMS-HCC V28: 1 category · CMS-HCC V22 category 18 · RxHCC V08 category 30

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

MS-DRG 008 — SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT (MDC PRE)
MS-DRG 010 — PANCREAS TRANSPLANT (MDC PRE)
MS-DRG 019 — SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS (MDC PRE)
MS-DRG 073 — CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC (MDC 01)
MS-DRG 074 — CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC (MDC 01)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

HCC 37 — Diabetes with Chronic Complications (supersedes HCC 38)

Other models: CMS-HCC V22 HCC 18 · RxHCC V08 HCC 30

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for E11.43 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on E11.43 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

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

Source: inherited from E11

Inclusion Terms

Alternative terms the tabular list files under this code.

Type 2 diabetes mellitus with diabetic gastroparesis

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

diabetes mellitus due to underlying condition (E08.-) Compare E11.43 vs E08 →
drug or chemical induced diabetes mellitus (E09.-) Compare E11.43 vs E09 →
gestational diabetes (O24.4-) Compare E11.43 vs O24.4 →
neonatal diabetes mellitus (P70.2) Compare E11.43 vs P70.2 →
postpancreatectomy diabetes mellitus (E13.-) Compare E11.43 vs E13 →
postprocedural diabetes mellitus (E13.-) Compare E11.43 vs E13 →
secondary diabetes mellitus NEC (E13.-) Compare E11.43 vs E13 →
type 1 diabetes mellitus (E10.-) Compare E11.43 vs E10 →

Source: inherited from E11

Use Additional Code

Supplementary codes the tabular list directs you to add.

Use additional 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)

Source: inherited from E11

Coder workflow for E11.43

MedCoder structured workflow — derived from this code’s own official record

Before you code E11.43

E11.43’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).
Guide: Combination codes →
Confirm the documented diabetes type or cause (the E08–E13 categories are separated by it) and every documented complication or manifestation; the code is built from the type first and the complication second. Then work the category’s Use Additional Code notes for medication and control status. Type 2 is the default only when the type is not documented, and insulin or other medication use does not by itself establish the type (Guidelines I.C.4.a.2, I.C.4.a.3).
Guide: Diabetes with multiple complications →
Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with E11.43. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
See the official tabular notes

Choose the right path

Does the documentation support a condition named in E11.43’s Excludes1 note?
Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
No → Continue.
ReviewE08, E09, O24.4, P70.2, E13, E10

Consider E11.43. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement: Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The associated condition or complication: Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
The conditions the Use Additional Code note names: Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
Diabetes type or cause, each complication, and medication use: The type is documented, not inferred from medication (Guidelines I.C.4.a.3); each documented complication takes its own combination code.

Official instructions as workflow

Excludes1 — check before selecting E11.43(8 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with E11.43: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
CompareE08, E09, O24.4, P70.2, E13, E10
See the official tabular notes · Guidelines I.A.12.a
Use Additional Code — after identifying E11.43(5 notes)
Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with E11.43 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.
ReviewZ79.85, Z79.4, Z79.84
See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition E11.43 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewE08, E09, O24.4, P70.2, E13, E10

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is E11.43 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with E11.43?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewZ79.85, Z79.4, Z79.84

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy is a billable ICD-10-CM diagnosis code (E11.43).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (6)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00 -E89)

2) Type of diabetes mellitus not documented If the type of diabetes mellitus is not documented in the medical record the default is E11.-, Type 2 diabetes mellitus.

Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00 -E89)

3) Diabetes mellitus and the use of insulin, oral hypoglycemics, and injectable non-insulin drugs If the documentation in a medical record does not indicate the type of diabetes but does indicate that the patient uses insulin, code E11-, Type 2 diabetes mellitus, should be assigned. Additional code(s) should be assigned from category Z79 to identify the long-term (current) use of insulin, oral hypoglycemic drugs, or injectable non-insulin antidiabetic, as follows: If the patient is treated with both oral hypoglycemic drugs and insulin, both code Z79.4, Long term (current) use of insulin, and code Z79.84, Long term (current) use of oral hypoglycemic drugs, should be assigned. If the patient is treated with both insulin and an injectable non-insulin antidiabetic drug, assign codes Z79.4, Long term (current) use of insulin, and Z79.85, Long-term (current) use of injectable non-insulin antidiabetic drugs. If the patient is treated with both oral hypoglycemic drugs and an injectable non-insulin antidiabetic drug, assign codes Z79.84, Long term (current) use of oral hypoglycemic drugs, and Z79.85, Long-term (current) use of injectable non-insulin antidiabetic drugs. Code Z79.4 should not be assigned if insulin is given temporarily to bring a type 2 patient’s blood sugar under control during an encounter.

Don’t confuse E11.43 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of E11.43 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

E08— Excludes1 conflict (Excludes1 — generally not reported together)
Not coded here — the tabular list excludes this pair for the same encounter.
Not reported together with this code, except where the two conditions are documented as unrelated.
What moves you there: Documentation of diabetes mellitus due to underlying condition moves the case to E08; the two are not reported together unless documented as unrelated.
Full comparison: E11.43 vs E08 →
E09— Excludes1 conflict (Excludes1 — generally not reported together)
Not coded here — the tabular list excludes this pair for the same encounter.
Not reported together with this code, except where the two conditions are documented as unrelated.
What moves you there: Documentation of drug or chemical induced diabetes mellitus moves the case to E09; the two are not reported together unless documented as unrelated.
Full comparison: E11.43 vs E09 →
O24.4— Excludes1 conflict (Excludes1 — generally not reported together)
Not coded here — the tabular list excludes this pair for the same encounter.
Not reported together with this code, except where the two conditions are documented as unrelated.
What moves you there: Documentation of gestational diabetes moves the case to O24.4; the two are not reported together unless documented as unrelated.
Full comparison: E11.43 vs O24.4 →
P70.2— Excludes1 conflict (Excludes1 — generally not reported together)
Not coded here — the tabular list excludes this pair for the same encounter.
Not reported together with this code, except where the two conditions are documented as unrelated.
What moves you there: Documentation of neonatal diabetes mellitus moves the case to P70.2; the two are not reported together unless documented as unrelated.
Full comparison: E11.43 vs P70.2 →
E13— Excludes1 conflict (Excludes1 — generally not reported together)
Not coded here — the tabular list excludes this pair for the same encounter.
Not reported together with this code, except where the two conditions are documented as unrelated.
What moves you there: Documentation of postpancreatectomy diabetes mellitus moves the case to E13; the two are not reported together unless documented as unrelated.
Full comparison: E11.43 vs E13 →
E10— Excludes1 conflict (Excludes1 — generally not reported together)
Not coded here — the tabular list excludes this pair for the same encounter.
Not reported together with this code, except where the two conditions are documented as unrelated.
What moves you there: Documentation of type 1 diabetes mellitus moves the case to E10; the two are not reported together unless documented as unrelated.
Full comparison: E11.43 vs E10 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name E11.43 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 3 Excludes2 notes across 3 chapters: H35 — Other retinal disorders (via E11.-), I96 — Gangrene, not elsewhere classified (via E11.-), K31 — Other diseases of stomach and duodenum.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 2 Code First instructions across 2 chapters: D84.81 — Immunodeficiency due to conditions classified elsewhere (via E11.-), K31.84 — Gastroparesis.

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Referenced by 1 Code Also instruction: N76.82 — Fournier disease of vagina and vulva (via E11.-).

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 5 MS-DRGs: DRG 008 (MDC PRE), DRG 010 (MDC PRE), DRG 019 (MDC PRE), DRG 073 (MDC 01), DRG 074 (MDC 01).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):END003 — Diabetes mellitus with complication (default); END005 — Diabetes mellitus, Type 2; NVS015 — Polyneuropathies.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Diabetes with Chronic Complications) for risk-adjusted payment.

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Pancreas Transplant Status, Diabetes with Severe Acute Complications, Diabetes with Glycemic, Unspecified, or No Complications

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Diabetes mellitus with complication, Diabetes mellitus, Type 2, Polyneuropathies).

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Diabetes, diabetic”; these codes share that main term but sit in a different category of the Tabular List.

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

HbA1c Test (Glycated Hemoglobin), Blood Glucose Test, Gamma-glutamyl Transferase (GGT) Test, Iron Panel, Lipid Panel, Thyroid Stimulating Hormone (TSH)

Contextual Map

Every relationship of E11.43 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run E11.43 with these 14 related codes in Claim Check

Hierarchy

E00-E89 — Chapter 4: Endocrine, Nutritional and Metabolic Diseases (E00-E89) (E00-E89)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
E08-E13 — Diabetes mellitus[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes1 notes (21)

E08 — Diabetes mellitus due to underlying condition[Excludes1](via E11.-): “type 2 diabetes mellitus (E11.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
E09 — Drug or chemical induced diabetes mellitus[Excludes1](via E11.-): “type 2 diabetes mellitus (E11.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
E10 — Type 1 diabetes mellitus[Excludes1](via E11.-): “type 2 diabetes mellitus (E11.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
E74 — Other disorders of carbohydrate metabolism[Excludes1](via E11.-): “diabetes mellitus (E08-E13)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
G54.5 — Neuralgic amyotrophy[Excludes1](via E11.-): “neuralgic amyotrophy in diabetes mellitus (E08-E13 with .44)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
G59 — Mononeuropathy in diseases classified elsewhere[Excludes1](via E11.-): “diabetic mononeuropathy (E08-E13 with .41)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
G63 — Polyneuropathy in diseases classified elsewhere[Excludes1](via E11.-): “diabetes mellitus (E08-E13 with .42)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
G99.0 — Autonomic neuropathy in diseases classified elsewhere[Excludes1](via E11.-): “diabetic autonomic neuropathy (E08-E13 with .43)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
and 13 more

Referenced by Excludes2 notes

H35 — Other retinal disorders[Excludes2](via E11.-): “diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
I96 — Gangrene, not elsewhere classified[Excludes2](via E11.-): “gangrene in diabetes mellitus (E08-E13 with .52)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
K31 — Other diseases of stomach and duodenum[Excludes2]: “diabetic gastroparesis (E08.43, E09.43, E10.43, E11.43, E13.43)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code First instructions

D84.81 — Immunodeficiency due to conditions classified elsewhere[Code First](via E11.-): “diabetes mellitus (E08-E13)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
K31.84 — Gastroparesis[Code First]: “diabetes mellitus (E08.43, E09.43, E10.43, E11.43, E13.43)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code Also instructions

N76.82 — Fournier disease of vagina and vulva[Code Also](via E11.-): “, if applicable, diabetes mellitus (E08-E13 with .9)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

END003 — Diabetes mellitus with complication[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
END005 — Diabetes mellitus, Type 2[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
NVS015 — Polyneuropathies[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

Risk adjustment (CMS-HCC)

HCC 37 — Diabetes with Chronic Complications [CMS-HCC]: “Diabetes with Chronic Complications — supersedes HCC 38 (Diabetes with Glycemic, Unspecified, or No Complications)”— CMS-HCC V28 · 2026

MS-DRG Grouper

DRG 008 — SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT[MS-DRG]: “SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT (MDC PRE)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
DRG 010 — PANCREAS TRANSPLANT[MS-DRG]: “PANCREAS TRANSPLANT (MDC PRE)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
DRG 019 — SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS[MS-DRG]: “SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS (MDC PRE)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
DRG 073 — CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC[MS-DRG]: “CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC (MDC 01)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
DRG 074 — CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC[MS-DRG]: “CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC (MDC 01)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

Pre-MDC[MDC crossing]: “Pre-MDC — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 153 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
MDC 01 — Diseases and Disorders of the Nervous System[MDC crossing]: “Diseases and Disorders of the Nervous System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 8,892 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

Diabetes, diabetic (mellitus) (sugar), type 2, with, autonomicneuropathy (poly)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Diabetes, diabetic (mellitus) (sugar), type 2, with, gastroparalysis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Diabetes, diabetic (mellitus) (sugar), type 2, with, gastroparesis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Diabetes, diabetic (mellitus) (sugar), with, autonomicneuropathy (poly)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Diabetes, diabetic (mellitus) (sugar), with, gastroparalysis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Diabetes, diabetic (mellitus) (sugar), with, gastroparesis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

E11 — Type 2 diabetes mellitus[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
E11.3551 — Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
E11.3552 — Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
E11.3553 — Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
E11.3559 — Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
E11.359 — Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
E11.3591 — Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
E11.3592 — Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
and 32 more

Change history

FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data: CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data: ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data: CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data: CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Risk adjustment Official source data: 2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data: CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship: Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation: Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "E11.43 — Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/e11.43-type-2-diabetes-mellitus-with-diabetic-autonomic-polyneuropathy

Change history

FY2016 — October 1, 2015
In the code set at ICD-10-CM adoption
Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to E11.43 in its code family, with their registry titles.

View all codes in the E11 family

E11.43 ICD-10-CM Code: Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy

Coding at a Glance

Inpatient Payment Groups (MS-DRG)

Risk Adjustment (CMS-HCC)

Coding instructions

Includes

Inclusion Terms

Excludes1 — Not Coded Here

Use Additional Code

Coder workflow for E11.43

Before you code E11.43

Choose the right path

Documentation check

Official instructions as workflow

Coding decision scenarios

Code Overview

Indexed Clinical Terms (6)

Official Coding Guidelines

Don’t confuse E11.43 with…

Verify Before Coding

Relationships & Classification

MS-DRG Grouper Relationships (FY2026)

Related Codes

Same CMS-HCC risk category (V28)

Related risk categories

Same clinical category (CCSR)

Same Index main term, other category

Lab tests where this diagnosis supports Medicare coverage (NCD)

Contextual Map

Hierarchy

Referenced by Excludes1 notes (21)

Referenced by Excludes2 notes

Referenced by Code First instructions

Referenced by Code Also instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

MS-DRG Grouper

MDC crossing

Index entries

Nearest codes (40)

Change history

Relevant guides

Sources for this page

Cite this page

Change history

Nearest Codes in This Family