E11.9: Type 2 diabetes mellitus without complications

The ICD-10-CM code for type 2 diabetes mellitus when the encounter documentation records no diabetic complication and no remission.

Billable

FY2027

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At a glance

Code Family

E11: Type 2 diabetes mellitus.

Condition

Type 2 diabetes

HCC Mapping (v28)

HCC 38: Diabetes with Glycemic, Unspecified, or No Complications.

DRG Grouping

MS-DRG 637, 638 or 639 under the FY2027 MS-DRG v44 grouper, assigned by the complications and comorbidities reported alongside the diagnosis.

Billable

Yes, valid for HIPAA covered transactions.

Family Specificity

E11 is a combination code family that carries the diabetic complication inside the code itself. E11.9 is the residual code for type 2 diabetes with no complication documented.

Which E11 code do I assign?

The E11 family is built on combination codes, each one carrying a documented diabetic complication inside the code itself. E11.9 belongs only where the record confirms active type 2 diabetes and documents neither a complication nor remission.

When documentation says…

Code

Type 2 diabetes with hyperglycemia

E11.65

Type 2 diabetes mellitus with hyperglycemia. The note must state the elevated glucose state. E11.65 is the more specific code and displaces E11.9.

Type 2 diabetes in remission

E11.A

Type 2 diabetes mellitus without complications in remission. Guideline I.C.4.a.1.b assigns E11.A on provider documentation that the diabetes is in remission. If the documentation is unclear, the provider is queried.

Type 2 diabetes with diabetic nephropathy

E11.21

Type 2 diabetes mellitus with diabetic nephropathy. The note must attribute the kidney disease to the diabetes. The combination code replaces E11.9.

Type 2 diabetes with diabetic chronic kidney disease

E11.22

Type 2 diabetes mellitus with diabetic chronic kidney disease. Add a code from N18 to identify the stage of chronic kidney disease.

Type 2 diabetes with diabetic polyneuropathy

E11.42

Type 2 diabetes mellitus with diabetic polyneuropathy. Documented diabetic neuropathy directs the encounter to the E11.40 through E11.49 codes rather than to E11.9.

Type 1 diabetes, patient on insulin

E10.9

Type 1 diabetes mellitus without complications. Diabetes type is assigned from provider documentation. Insulin use does not make a patient type 1. A type 2 patient on insulin takes E11.9 with Z79.4 (Guideline I.C.4.a.3).

Type 2 diabetes, no complication documented

E11.9

Type 2 diabetes mellitus without complications. Correct when the provider documents active type 2 diabetes and the record names no nephropathy, retinopathy, neuropathy, peripheral circulatory disorder or other diabetic complication.

Tabular notes

USE ADDITIONAL

Use additional code to identify control using injectable non-insulin antidiabetic drugs (Z79.85), insulin (Z79.4), oral antidiabetic drugs (Z79.84) or oral hypoglycemic drugs (Z79.84). Report Z79.4 when the patient is on long term insulin. Report Z79.4 and Z79.84 together when the patient uses both insulin and an oral agent.

EXCLUDES1

Category E11 carries an Excludes1 note for diabetes mellitus due to underlying condition (E08.-), drug or chemical induced diabetes mellitus (E09.-), gestational diabetes (O24.4-), neonatal diabetes mellitus (P70.2), postpancreatectomy diabetes mellitus, postprocedural diabetes mellitus and secondary diabetes mellitus NEC (E13.-), and type 1 diabetes mellitus (the E10 codes). A code from E10 and a code from E11 are not reported together for the same condition. E11.9 carries its own Excludes1 note for type 2 diabetes mellitus, without complications in remission (E11.A).

FY2027: EFFECTIVE 1 OCTOBER 2026

The FY2027 codes and tabular addenda make no addition, deletion or revision in category E11. E11.9 is unchanged in the FY2027 update. E11.A, type 2 diabetes mellitus without complications in remission, is a separate code. E11.9 remains the code for active type 2 diabetes without complications.

Operational & financial impact

Why specificity matters beyond the chart: risk adjustment, DRG assignment and denial exposure all follow from which code is selected.

CMS-HCC v28 (PY2024+)

HCC 38: Diabetes with Glycemic, Unspecified, or No Complications.

E11.9 and E11.65 map to the same HCC category under CMS-HCC v28.

For Medicare Advantage risk adjustment, diabetes must be documented and coded at least once per calendar year from a qualifying face to face encounter to recapture HCC 38.

V24 TO V28 TRANSITION

CMS-HCC v24 spread type 2 diabetes across HCC 17, HCC 18 and HCC 19.

Version 28 regrouped the diabetes codes into HCC 36, HCC 37 and HCC 38. E11.9 maps to HCC 38.

MS-DRG v44 (FY2027)

MS-DRG 637, 638 and 639: the diabetes groups in MDC 10 reached when E11.9 is the principal diagnosis under the FY2027 MS-DRG v44 grouper.

The tier within that group follows the complications and comorbidities reported alongside the diagnosis.

Documented ketoacidosis or hyperosmolarity moves the diabetes code off E11.9 to a code in subcategory E11.0 or E11.1. E11.00 and E11.10 are on the FY2027 MCC list.

WHERE SPECIFICITY IS LOST

E11.9 records only that no diabetic complication was documented at the encounter.

A documented complication moves the encounter to an E11 combination code. Several of those combination codes carry a higher HCC category than HCC 38.

Review each encounter for nephropathy, retinopathy, neuropathy and peripheral circulatory disorders before settling on E11.9.

Laboratory values such as HbA1c and eGFR that point to a complication the provider has not documented warrant a query.

Medicare and commercial payers

Medicare covers diabetes self management training and therapeutic shoes and inserts for diabetic patients.

Documentation checklist to support E11.9

Chart elements that support code selection and reduce specificity-driven denials.

Type 2 diabetes mellitus documented as an active diagnosis, not as a historical condition and not as resolved.

A record that names no diabetic nephropathy, retinopathy, neuropathy, peripheral circulatory disorder or other organ involvement.

No provider documentation of remission, which would direct the encounter to E11.A instead.

Current insulin use documented explicitly, to support Z79.4 as a Use Additional code.

Current oral antidiabetic or injectable non-insulin agent use, to support Z79.84 or Z79.85.

Provider documentation of the diabetes type, because insulin use alone does not establish type 1 or type 2.

Evidence of active management within the calendar year, to support annual recapture of HCC 38 under CMS-HCC v28.

A review of laboratory values such as HbA1c and eGFR for findings that suggest a complication the note has not yet recorded.

FAQ

Is E11.9 a billable code?

Yes. E11.9 is a valid billable code for HIPAA covered transactions in the FY2027 ICD-10-CM code set, effective 1 October 2026.

What is the difference between E11.9 and E11.65?

E11.9 applies when no complication and no hyperglycemia are documented. E11.65 applies when the provider documents type 2 diabetes with hyperglycemia. Both map to HCC 38 under CMS-HCC v28. Assign the most specific code the provider documentation supports.

When should I use E11.A instead of E11.9?

Use E11.A when the provider explicitly documents type 2 diabetes in remission. Guideline I.C.4.a.1.b assigns E11.A on provider documentation of remission and directs a query when the documentation is unclear. The term resolved is not synonymous with remission. E11.9 remains correct for active type 2 diabetes without complications.

Does E11.9 map to an HCC in 2026?

Yes. E11.9 maps to HCC 38, Diabetes with Glycemic, Unspecified, or No Complications, under CMS-HCC v28. The diagnosis must be documented and coded at least once per calendar year from a qualifying encounter to recapture the category.

Should I report both Z79.4 and Z79.84 for a patient on insulin and an oral agent?

Yes. Report Z79.4 for long term insulin use and Z79.84 for long term oral hypoglycemic drug use when the patient is on both. Guideline I.C.4.a.3 calls for both codes in this situation. Both are reported as additional codes with the E11 code.

Can I assign E11.9 for a type 2 patient who takes insulin?

Yes. Diabetes type is assigned from provider documentation alone. Insulin use does not make a patient type 1. A type 2 patient on insulin takes E11.9 with Z79.4 as an additional code.

How does E11.9 differ between outpatient and inpatient coding?

In the outpatient setting E11.9 is the standard code for a diabetes management visit with no documented complication. On the inpatient side it is reported as a secondary diagnosis when diabetes contributes to the encounter. When a diabetic complication is the reason for admission, the complication code leads.

What changed for E11.9 in FY2027?

E11.9 is unchanged in the FY2027 update, effective 1 October 2026. The FY2027 codes and tabular addenda make no addition, deletion or revision in category E11. Category E11 carries E11.A, type 2 diabetes mellitus without complications in remission, as a separate code. Documented remission takes E11.A rather than E11.9.

Related codes

Codes in the same family as E11.9. Only codes with a published page render as links.

Sibling codes in the E11 family

E11.00: Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC).
E11.10: Type 2 diabetes mellitus with ketoacidosis without coma.
E11.21: Type 2 diabetes mellitus with diabetic nephropathy.
E11.22: Type 2 diabetes mellitus with diabetic chronic kidney disease.
E11.319: Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema.
E11.40: Type 2 diabetes mellitus with diabetic neuropathy, unspecified.
E11.42: Type 2 diabetes mellitus with diabetic polyneuropathy.
E11.51: Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene.
E11.52: Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene.
E11.649: Type 2 diabetes mellitus with hypoglycemia without coma.
E11.65: Type 2 diabetes mellitus with hyperglycemia.
E11.8: Type 2 diabetes mellitus with unspecified complications.
E11.A: Type 2 diabetes mellitus without complications in remission.

Additional codes to consider

Codes outside the E11 family considered alongside E11.9.

Companion: code alongside when documented

Z79.4: Long term (current) use of insulin. Required as a Use Additional code when the patient is on long term insulin.
Z79.84: Long term (current) use of oral hypoglycemic drugs. Report when the patient is on an oral antidiabetic agent, under the Use additional note at category E11.
Z79.85: Long-term (current) use of injectable non-insulin antidiabetic drugs. Report for GLP-1 receptor agonists and other injectable non-insulin therapies, under the Use additional note at category E11.

Consider instead

E11.A: Type 2 diabetes mellitus without complications in remission. Use when the provider documents remission.
E11.65: Type 2 diabetes mellitus with hyperglycemia. Use when the note documents an elevated glucose state.
E11.21: Type 2 diabetes mellitus with diabetic nephropathy. Use when diabetic kidney disease is documented.
E11.22: Type 2 diabetes mellitus with diabetic chronic kidney disease. Add a code from N18 for the stage.
E11.319: Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema. Use when retinopathy is documented without a stated severity.
E11.42: Type 2 diabetes mellitus with diabetic polyneuropathy. Use when diabetic polyneuropathy is documented.
E11.51: Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene. Use when diabetic peripheral circulatory disease is documented.
E11.8: Type 2 diabetes mellitus with unspecified complications. Use when a complication is documented but not specified.
E10.9: Type 1 diabetes mellitus without complications. Use when the provider documents type 1 diabetes.

Sources

All claims on this page derive from government and professional-standards sources.

National Center for Health Statistics. (2026). International classification of diseases, tenth revision, clinical modification (ICD-10-CM) FY2027 files. https://www.cdc.gov/nchs/icd/icd-10-cm/files.html
Centers for Medicare & Medicaid Services and National Center for Health Statistics. (2026). ICD-10-CM official guidelines for coding and reporting FY2027. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2027/ICD-10-CM-October-1-2026-FY27-Guidelines.pdf
Centers for Medicare & Medicaid Services. (2025). 2026 model software/ICD-10 mappings. https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment/2026-model-software-icd-10-mappings
Centers for Medicare & Medicaid Services. (2026). MS-DRG classifications and software, version 44. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/ms-drg-classifications-and-software