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

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Coding at a Glance

Tabular directives
5 inclusion terms · 7 Excludes1 · 5 use-additional 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: FY2026Effective: October 1, 2025

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. “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on E13; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  3. 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) →

  4. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with 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; query for the specificity its subcategory needs.

    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

Consider E13. 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 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 sibling 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 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.

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

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 structured 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-fy2026
  • 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-fy2026
  • I96 — Gangrene, not elsewhere classified[Excludes2]: “gangrene in diabetes mellitus (E08-E13 with .52)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

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

Common coding questions

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 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
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. "E13 — Other specified diabetes mellitus." ICD-10-CM FY2026. 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 (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 E13 in its code family, with their registry titles.