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E11.649 ICD-10-CM Code: Type 2 diabetes mellitus with hypoglycemia without coma

Compare with another codeCheck this code on a claim

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

Coding at a Glance

Tabular directives
3 inclusion terms · 8 Excludes1 · 6 use-additional codes
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 18 · RxHCC V08 category 30

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Use additional codeReport with this code when documented
  • code for hypoglycemia level, if applicable (E16.A-)
  • code to identify control using:
  • injectable non-insulin antidiabetic drugs (Z79.85)
  • insulin (Z79.4)

+2 more in Instructions

Excludes1Never report with this code
  • diabetes mellitus due to underlying condition (E08.-)
  • drug or chemical induced diabetes mellitus (E09.-)
  • gestational diabetes (O24.4-)
  • neonatal diabetes mellitus (P70.2)

+4 more in Instructions

IncludesWhat this code covers
  • diabetes (mellitus) due to insulin secretory defect
  • diabetes NOS
  • insulin resistant diabetes (mellitus)

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

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 v44, Appendix B.

  • MS-DRG 008 — SIMULTANEOUS PANCREAS, ISLET CELL AND KIDNEY TRANSPLANT (MDC PRE)
  • MS-DRG 010 — PANCREAS OR ISLET CELL TRANSPLANT (MDC PRE)
  • MS-DRG 019 — SIMULTANEOUS PANCREAS, ISLET CELL AND KIDNEY TRANSPLANT WITH HEMODIALYSIS (MDC PRE)
  • MS-DRG 637 — DIABETES WITH MCC (MDC 10)
  • MS-DRG 638 — DIABETES WITH CC (MDC 10)
  • MS-DRG 639 — DIABETES WITHOUT CC/MCC (MDC 10)

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 38 — Diabetes with Glycemic, Unspecified, or No Complications

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 E11.649 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on E11.649 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

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).

Source: inherited from E11

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code for hypoglycemia level, if applicable (E16.A-) inherited from E11.64
  • Use additional code to identify control using:
  • injectable non-insulin antidiabetic drugs (Z79.85) inherited from E11
  • insulin (Z79.4) inherited from E11
  • oral antidiabetic drugs (Z79.84) inherited from E11
  • oral hypoglycemic drugs (Z79.84) inherited from E11

Coder workflow for E11.649

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

Before you code E11.649

  1. 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 →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with E11.649. 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

  1. Does the documentation support a condition named in E11.649’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 E11.649. 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 E11.649(8 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with E11.649: 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 E11.649(6 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with E11.649 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewE16.A, Z79.85, 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 E11.649 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: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with E11.649?

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).

ReviewE16.A, Z79.85, 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.

Don’t confuse E11.649 with…

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

The codes most likely to be picked instead of E11.649 — 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: E11.649 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: E11.649 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: E11.649 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: E11.649 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: E11.649 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: E11.649 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.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Type 2 diabetes mellitus with hypoglycemia without coma is a billable ICD-10-CM diagnosis code (E11.649).

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

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.

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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name E11.649 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.

Referenced by 23 Excludes1 notes across 8 chapters: E08 — Diabetes mellitus due to underlying condition (via E11.-), E09 — Drug or chemical induced diabetes mellitus (via E11.-), E10 — Type 1 diabetes mellitus (via E11.-), E16.1 — Other hypoglycemia, E16.2 — Hypoglycemia, unspecified, E74 — Other disorders of carbohydrate metabolism (via E11.-), G54.5 — Neuralgic amyotrophy (via E11.-), G59 — Mononeuropathy in diseases classified elsewhere (via E11.-), G63 — Polyneuropathy in diseases classified elsewhere (via E11.-), G99.0 — Autonomic neuropathy in diseases classified elsewhere (via E11.-), H20.0 — Acute and subacute iridocyclitis (via E11.-), I73.8 — Other specified peripheral vascular diseases (via E11.-), I79.8 — Other disorders of arteries, arterioles and capillaries in diseases classified elsewhere (via E11.-), L92.1 — Necrobiosis lipoidica, not elsewhere classified (via E11.-), L99 — Other disorders of skin and subcutaneous tissue in diseases classified elsewhere (via E11.-), M14 — Arthropathies in other diseases classified elsewhere (via E11.-), M14.6 — Charcôt's joint (via E11.-), M90 — Osteopathies in diseases classified elsewhere (via E11.-), N08 — Glomerular disorders in diseases classified elsewhere (via E11.-), N16 — Renal tubulo-interstitial disorders in diseases classified elsewhere (via E11.-), +3 more.

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

Referenced by 2 Excludes2 notes across 2 chapters: H35 — Other retinal disorders (via E11.-), I96 — Gangrene, not elsewhere classified (via E11.-).

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

Referenced by 1 Code First instruction: D84.81 — Immunodeficiency due to conditions classified elsewhere (via E11.-).

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 (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 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 6 MS-DRGs: DRG 008 (MDC PRE), DRG 010 (MDC PRE), DRG 019 (MDC PRE), DRG 637 (MDC 10), DRG 638 (MDC 10), DRG 639 (MDC 10).

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.

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 Glycemic, Unspecified, or No Complications) for risk-adjusted payment.

E08.649 — Diabetes mellitus due to underlying condition with hypoglycemia without coma, E08.65 — Diabetes mellitus due to underlying condition with hyperglycemia, E08.8 — Diabetes mellitus due to underlying condition with unspecified complications, E08.9 — Diabetes mellitus due to underlying condition without complications, E10.649 — Type 1 diabetes mellitus with hypoglycemia without coma, E10.65 — Type 1 diabetes mellitus with hyperglycemia, E10.8 — Type 1 diabetes mellitus with unspecified complications, E10.9 — Type 1 diabetes mellitus without complications, E11.65 — Type 2 diabetes mellitus with hyperglycemia, E11.8 — Type 2 diabetes mellitus with unspecified complications, E11.9 — Type 2 diabetes mellitus without complications, E13.649 — Other specified diabetes mellitus with hypoglycemia without coma, E13.65 — Other specified diabetes mellitus with hyperglycemia, E13.8 — Other specified diabetes mellitus with unspecified complications, E13.9 — Other specified diabetes mellitus without complications, Z79.4 — Long term (current) use of insulin

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 Chronic 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).

E11.59 — Type 2 diabetes mellitus with other circulatory complications, E11.610 — Type 2 diabetes mellitus with diabetic neuropathic arthropathy, E11.618 — Type 2 diabetes mellitus with other diabetic arthropathy, E11.620 — Type 2 diabetes mellitus with diabetic dermatitis, 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, E11.630 — Type 2 diabetes mellitus with periodontal disease, E11.638 — Type 2 diabetes mellitus with other oral complications, E11.641 — Type 2 diabetes mellitus with hypoglycemia with coma, E11.65 — Type 2 diabetes mellitus with hyperglycemia, E11.69 — Type 2 diabetes mellitus with other specified complication, E11.8 — Type 2 diabetes mellitus with unspecified complications, E11.9 — Type 2 diabetes mellitus without complications, E11.A — Type 2 diabetes mellitus without complications in remission, O24.111 — Pre-existing type 2 diabetes mellitus, in pregnancy, first trimester, O24.112 — Pre-existing type 2 diabetes mellitus, in pregnancy, second trimester, O24.113 — Pre-existing type 2 diabetes mellitus, in pregnancy, third trimester, O24.119 — Pre-existing type 2 diabetes mellitus, in pregnancy, unspecified trimester, O24.12 — Pre-existing type 2 diabetes mellitus, in childbirth, +450 more

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.

E10.641 — Type 1 diabetes mellitus with hypoglycemia with coma (type 1, with, hypoglycemia, with coma), E10.649 — Type 1 diabetes mellitus with hypoglycemia without coma (type 1, with, hypoglycemia), E10.65 — Type 1 diabetes mellitus with hyperglycemia (type 1, with, hyperglycemia), E10.69 — Type 1 diabetes mellitus with other specified complication (type 1, with, osteomyelitis), E10.8 — Type 1 diabetes mellitus with unspecified complications (type 1, with, complication), E10.9 — Type 1 diabetes mellitus without complications (type 1), E10.A — Type 1 diabetes mellitus, presymptomatic (type 1, early-stage), E10.A0 — Type 1 diabetes mellitus, presymptomatic, unspecified (type 1, presymptomatic), E10.A1 — Type 1 diabetes mellitus, presymptomatic, Stage 1 (type 1, presymptomatic, Stage 1), E10.A2 — Type 1 diabetes mellitus, presymptomatic, Stage 2 (type 1, presymptomatic, Stage 2), E13.00 — Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) (specified type NEC, with, hyperosmolarity), E13.01 — Other specified diabetes mellitus with hyperosmolarity with coma (specified type NEC, with, hyperosmolarity, with coma), E13.10 — Other specified diabetes mellitus with ketoacidosis without coma (specified type NEC, with, ketoacidosis), E13.11 — Other specified diabetes mellitus with ketoacidosis with coma (specified type NEC, with, ketoacidosis, with coma), E13.21 — Other specified diabetes mellitus with diabetic nephropathy (specified type NEC, with, nephropathy), E13.22 — Other specified diabetes mellitus with diabetic chronic kidney disease (specified type NEC, with, chronic kidney disease), E13.29 — Other specified diabetes mellitus with other diabetic kidney complication (specified type NEC, with, renal complication NEC), E13.311 — Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema (specified type NEC, with, retinopathy, with macular edema), E13.319 — Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema (specified type NEC, with, retinopathy), E13.321 — Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema (specified type NEC, with, retinopathy, nonproliferative, with macular edema), +190 more

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 E11.649 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 E11.649 with these 12 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes (23)

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-fy2027
  • I96 — Gangrene, not elsewhere classified[Excludes2](via E11.-): “gangrene in diabetes mellitus (E08-E13 with .52)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Code First instructions

Referenced by Code Also instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 38 — Diabetes with Glycemic, Unspecified, or No Complications [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

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. 175 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
  • MDC 10 — Endocrine, Nutritional and Metabolic Diseases and Disorders[MDC crossing]: “Endocrine, Nutritional and Metabolic Diseases and Disorders — 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. 5,013 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Diabetes, diabetic (mellitus) (sugar), type 2, with, hypoglycemia[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Diabetes, diabetic (mellitus) (sugar), with, hypoglycemia[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (40)

Change history

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

Relevant guides

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (2)

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.

Common coding questions

MedCoder editorial

What keeps E11.649 out of the severe-acute HCC?

The absence of coma. Without it, hypoglycemia stays in V28 HCC 38 (Diabetes with Glycemic, Unspecified, or No Complications); the same event with documented coma is E11.641 and HCC 36. The E16.A- hypoglycemia-level code applies to both when documented.

E11.649 or E16.2 for hypoglycemia in a type 2 diabetic?

E11.649 — the diabetes combination code carries the hypoglycemia, per the same “with” presumption that runs through the whole family; a standalone hypoglycemia code belongs to patients whose hypoglycemia is not attributed to diabetes. See the ICD-10 “with” convention.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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 — v44 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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

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. "E11.649 — Type 2 diabetes mellitus with hypoglycemia without coma." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/e11.649-type-2-diabetes-mellitus-with-hypoglycemia-without-coma

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Type 2 diabetes mellitus with hypoglycemia without coma

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, 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 E11.649 in its code family, with their registry titles.

View all codes in the E11 family