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E13 ICD-10-CM Code: Other specified diabetes mellitus

Compare with another code for E13Check this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

Official instructions
5 inclusion terms · 7 Excludes1 · 5 use-additional instructions

What these terms mean →

Category · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

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, and is marked with where it comes from.

Use additional codeReport with this code when documented
  • Use additional code to identify control using:
  • injectable non-insulin antidiabetic drugs (Z79.85)
  • insulin (Z79.4)
  • oral antidiabetic drugs (Z79.84)

+1 more in Instructions

Excludes1Not reported with this code unless documented as unrelated
  • diabetes (mellitus) due to autoimmune process (E10.-)
  • diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)
  • diabetes mellitus due to underlying condition (E08.-)
  • drug or chemical induced diabetes mellitus (E09.-)

+3 more in Instructions

IncludesWhat this code covers
  • diabetes mellitus due to genetic defects of beta-cell function
  • diabetes mellitus due to genetic defects in insulin action
  • postpancreatectomy diabetes mellitus
  • postprocedural diabetes mellitus

+1 more in Instructions

Where it sits Source: CMS/NCHS

Under:Chapter 4: Endocrine, Nutritional and Metabolic DiseasesE08-E13 Diabetes mellitus

Codes under E13 (9)

  • E13.0Other specified diabetes mellitus with hyperosmolarityNot billable
  • E13.1Other specified diabetes mellitus with ketoacidosisNot billable
  • E13.2Other specified diabetes mellitus with kidney complicationsNot billable
  • E13.3Other specified diabetes mellitus with ophthalmic complicationsNot billable
  • E13.4Other specified diabetes mellitus with neurological complicationsNot billable
  • E13.5Other specified diabetes mellitus with circulatory complicationsNot billable
  • E13.6Other specified diabetes mellitus with other specified complicationsNot billable
  • E13.8Other specified diabetes mellitus with unspecified complicationsBillable
  • E13.9Other specified diabetes mellitus without complicationsBillable

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

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for E13 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

Includes

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

  • diabetes mellitus due to genetic defects of beta-cell function
  • diabetes mellitus due to genetic defects in insulin action
  • postpancreatectomy diabetes mellitus
  • postprocedural diabetes mellitus
  • secondary diabetes mellitus NEC

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).

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)

Coder workflow for E13

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

Before you code E13

  1. E13 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewE13.0, E13.1, E13.2, E13.3, E13.4, E13.5, E13.6, E13.8, E13.9

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. 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: Secondary diabetes (E08, E09, E13) →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with the code beneath E13. 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 one of the more specific codes beneath E13?
    Yes → Select that code and continue the checks below on its own page.
    No → E13 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewE13.0, E13.1, E13.2, E13.3, E13.4, E13.5, E13.6, E13.8, E13.9

  2. Does the documentation support a condition named in E13’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.

    ReviewE10, E08, E09, O24.4, P70.2

Report the code beneath E13 that the documentation supports, not E13 itself. Then work the Use Additional Code note, and confirm that code is valid for the date of service on its own page.

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 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.
Any detail beyond this code’s title
What the record states that a more specific code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes1 — check before selecting E13(7 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with E13: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareE10, E08, E09, O24.4, P70.2

    See the official tabular notes · Guidelines I.A.12.a

  • Use Additional Code — after identifying E13(5 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with E13 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 E13 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).

ReviewE10, E08, E09, O24.4, P70.2

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

Coding question: Is a second code reported with the code beneath E13?

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.

Don’t confuse E13 with…

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

The codes most likely to be picked instead of E13 — 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.

  • 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 diabetes (mellitus) due to autoimmune process moves the case to E10; the two are not reported together unless documented as unrelated.

    Full comparison: E13 vs E10 →

  • 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: E13 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: E13 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: E13 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: E13 vs P70.2 →

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

Other specified diabetes mellitus is a non-billable ICD-10-CM category code (E13). A more specific billable subcode must be selected for claims submission.

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)

a. Diabetes mellitus 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.

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

6) Secondary diabetes mellitus Codes under categories E08, Diabetes mellitus due to underlying condition, E09, Drug or chemical induced diabetes mellitus, and E13, Other specified diabetes mellitus, identify complications/manifestations associated with secondary diabetes mellitus. Secondary diabetes is always caused by another condition or event (e.g., cystic fibrosis, malignant neoplasm of pancreas, pancreatectomy, adverse effect of drug, or poisoning).

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

(b) Assigning and sequencing secondary diabetes codes and its causes The sequencing of the secondary diabetes codes in relationship to codes for the cause of the diabetes is based on the Tabular List instructions for categories E08, E09 and E13.

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

(i) Secondary diabetes mellitus due to pancreatectomy For postpancreatectomy diabetes mellitus (lack of insulin due to the surgical removal of all or part of the pancreas), assign code E89.1, Postprocedural hypoinsulinemia. Assign a code from category E13 as the principal or first- listed diagnosis and a code from subcategory Z90.41, Acquired absence of pancreas, as an additional code. (ii) Secondary diabetes due to drugs Secondary diabetes may be caused by an adverse effect of correctly administered medications, poisoning or sequela of poisoning. See section I.C.19.e. for coding of adverse effects and poisoning, and section I.C.20 for external cause code reporting.

Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)

g. Diabetes mellitus in pregnancy Diabetes mellitus is a significant complicating factor in pregnancy. Pregnant patients who are diabetic should be assigned a code from category O24, Diabetes mellitus in pregnancy, childbirth, and the puerperium, first, followed by the appropriate diabetes code(s) (E08-E13) from Chapter 4.

Verify Before Coding

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 E13 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 22 Excludes1 notes across 8 chapters: E08 — Diabetes mellitus due to underlying condition, E09 — Drug or chemical induced diabetes mellitus, E10 — Type 1 diabetes mellitus, E11 — Type 2 diabetes mellitus, E74 — Other disorders of carbohydrate metabolism, G54.5 — Neuralgic amyotrophy, G59 — Mononeuropathy in diseases classified elsewhere, G63 — Polyneuropathy in diseases classified elsewhere, G99.0 — Autonomic neuropathy in diseases classified elsewhere, H20.0 — Acute and subacute iridocyclitis, I73.8 — Other specified peripheral vascular diseases, I79.8 — Other disorders of arteries, arterioles and capillaries in diseases classified elsewhere, L92.1 — Necrobiosis lipoidica, not elsewhere classified, L99 — Other disorders of skin and subcutaneous tissue in diseases classified elsewhere, M14 — Arthropathies in other diseases classified elsewhere, M14.6 — Charcôt's joint, M90 — Osteopathies in diseases classified elsewhere, N08 — Glomerular disorders in diseases classified elsewhere, N16 — Renal tubulo-interstitial disorders in diseases classified elsewhere, N76.82 — Fournier disease of vagina and vulva, +2 more.

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: E87.0 — Hyperosmolality and hypernatremia, H35 — Other retinal disorders, I96 — Gangrene, not elsewhere classified.

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, E89.1 — Postprocedural hypoinsulinemia.

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 Use Additional Code instruction: Z90.41 — Acquired absence of pancreas.

These codes instruct coders to additionally report this code when it applies.

Referenced by 1 Code Also instruction: N76.82 — Fournier disease of vagina and vulva.

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

Contextual Map

Every relationship of E13 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 E13 with these 20 related codes in Claim Check

Hierarchy

Excludes1

Use Additional Code

Referenced by Excludes1 notes (22)

Referenced by Excludes2 notes

  • E87.0 — Hyperosmolality and hypernatremia[Excludes2]: “diabetes with hyperosmolarity (E08, E09, E11, E13 with final characters .00 or .01)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • H35 — Other retinal disorders[Excludes2]: “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]: “gangrene in diabetes mellitus (E08-E13 with .52)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Code First instructions

Referenced by Use Additional Code instructions

Referenced by Code Also instructions

Nearest codes (115)

Change history

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

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.

Common coding questions

MedCoder editorial

Can E13 be billed directly?

No. E13 (Other specified diabetes mellitus) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

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
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 28, 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. "E13 — Other specified diabetes mellitus." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/e13-other-specified-diabetes-mellitus

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Other specified diabetes mellitus

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 E13 in its code family, with their registry titles.