ICD-10-CM Diagnosis Code E11.9 - Type 2 diabetes mellitus without complications (original) (raw)

ICD List Logo

ICD List 2025-2026 Edition

  1. Home
  2. ICD-10-CM Codes
  3. E00–E89
  4. E08-E13
  5. E11
  6. 2026 ICD-10-CM Code E11.9

Type 2 diabetes mellitus without complications

ICD-10-CM Code:

E11.9

ICD-10 Code for:

Type 2 diabetes mellitus without complications

Is Billable?

Yes - Valid for Submission

Chronic Condition Indicator: [1]

Chronic

Code Navigator:

E11.9 is a billable diagnosis code used to specify a medical diagnosis of type 2 diabetes mellitus without complications. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2025 through September 30, 2026.

This code is not usually sufficient justification for admission to an acute care hospital when used as a principal diagnosis.

This medical diagnosis code is frequently used in Family Practice, Internal Medicine, Pediatrics, and Family Practice medical specialties to designate conditions such diabetes mellitus w/o complications type 2.

The code is linked to some Quality Measures as part of Medicare's Quality Payment Program (QPP). When this code is used as part of a patient's medical record the following Quality Measures might apply: Diabetes: Hemoglobin A1c (hba1c) Poor Control (>9%).

  1. Code Information
  2. Approximate Synonyms
  3. Clinical Classification
  4. Clinical Information
  5. Coding Guidelines
  6. Replaced Code
  7. Tabular List of Diseases and Injuries
  8. Index to Diseases and Injuries References
  10. Code Edits
  11. Diagnostic Related Groups Mapping
  12. Convert to ICD-9 Code
  13. Quality Payment Program Measures
  14. Patient Education
  15. Other Codes Used Similar Conditions
  16. Code History

The following list of clinical terms are approximate synonyms, alternative descriptions, or common phrases that might be used by patients, healthcare providers, or medical coders to describe the same condition. These synonyms and related diagnosis terms are often used when searching for an ICD-10 code, especially when the exact medical terminology is unclear. Whether you're looking for lay terms, similar diagnosis names, or common language alternatives, this list can help guide you to the correct ICD-10 classification.

Clinical Classifications group individual ICD-10-CM diagnosis codes into broader, clinically meaningful categories. These categories help simplify complex data by organizing related conditions under common clinical themes.

They are especially useful for data analysis, reporting, and clinical decision-making. Even when diagnosis codes differ, similar conditions can be grouped together based on their clinical relevance. Each category is assigned a unique CCSR code that represents a specific clinical concept, often tied to a body system or medical specialty.

CCSR Code: END002

Inpatient Default: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.

Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

CCSR Code: END005

Inpatient Default: N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.

Outpatient Default: N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

a circumscribed melanosis consisting of a brown-pigmented, velvety verrucosity or fine papillomatosis appearing in the axillae and other body folds. it occurs in association with endocrine disorders, underlying malignancy, administration of certain drugs, or as in inherited disorder.

conditions or pathological processes associated with the disease of diabetes mellitus. due to the impaired control of blood glucose level in diabetic patients, pathological processes develop in numerous tissues and organs including the eye, the kidney, the blood vessels, and the nerve tissue.

a heterogeneous group of disorders characterized by hyperglycemia and glucose intolerance.

diabetes mellitus induced experimentally by administration of various diabetogenic agents or by pancreatectomy.

a type of diabetes mellitus that is characterized by severe insulin resistance and lipodystrophy. the latter may be generalized, partial, acquired, or congenital (lipodystrophy, congenital generalized).

a subtype of diabetes mellitus that is characterized by insulin deficiency. it is manifested by the sudden onset of severe hyperglycemia, rapid progression to diabetic ketoacidosis, and death unless treated with insulin. the disease may occur at any age, but is most common in childhood or adolescence.

a subclass of diabetes mellitus that is not insulin-responsive or dependent (niddm). it is characterized initially by insulin resistance and hyperinsulinemia; and eventually by glucose intolerance; hyperglycemia; and overt diabetes. type ii diabetes mellitus is no longer considered a disease exclusively found in adults. patients seldom develop ketosis but often exhibit obesity.

diabetes mellitus induced by pregnancy but resolved at the end of pregnancy. it does not include previously diagnosed diabetics who become pregnant (pregnancy in diabetics). gestational diabetes usually develops in late pregnancy when insulin antagonistic hormones peaks leading to insulin resistance; glucose intolerance; and hyperglycemia.

autoimmune diabetes in adults with slowly progressive pancreatic beta cell failure and the presence of circulating autoantibodies to pancreatic islets cell antigens.

autoimmune diseases affecting multiple endocrine organs. type i is characterized by childhood onset and chronic mucocutaneous candidiasis (candidiasis, chronic mucocutaneous), while type ii exhibits any combination of adrenal insufficiency (addison's disease), lymphocytic thyroiditis (thyroiditis, autoimmune;), hypoparathyroidism; and gonadal failure. in both types organ-specific antibodies against a variety of endocrine glands have been detected. the type ii syndrome differs from type i in that it is associated with hla-a1 and b8 haplotypes, onset is usually in adulthood, and candidiasis is not present.

diminished effectiveness of insulin in lowering blood sugar levels: requiring the use of 200 units or more of insulin per day to prevent hyperglycemia or ketosis.

a cluster of symptoms that are risk factors for cardiovascular diseases and type 2 diabetes mellitus. the major components of metabolic syndrome include abdominal obesity; atherogenic dyslipidemia; hypertension; hyperglycemia; insulin resistance; a proinflammatory state; and a prothrombotic (thrombosis) state.

surgical removal of the pancreas. (dorland, 28th ed)

a melanotic cutaneous lesion that develops in the axilla and other body folds. it may be idiopathic, drug-induced, or it may be associated with the presence of an endocrine disorder or malignancy.

a condition characterized by hyperandrogenism, insulin resistance, and acanthosis nigricans, typically associated with obesity in teenage girls. it is considered to be a subtype of polycystic ovarian syndrome, but may occur in male individuals. etiology is unclear, but some cases may be associated with mutations affecting the tyrosine kinase domain of the insulin receptor.

a syndrome of insulin resistance caused by mutation(s) in the insr gene, encoding the insulin receptor. this condition is characterized by a clinical triad of hyperinsulinemia, acanthosis nigricans, and hyperandrogenism without lipodystrophy. this is the least severe of a spectrum of disorders; the other two conditions are rabson-mendenhall syndrome and donohoe syndrome.

an assessment of beta-cell function and insulin resistance based on fasting blood glucose and insulin concentrations.

insulin resistance caused by inactivating mutation(s) in the insr gene encoding the insulin receptor.

decreased sensitivity to circulating insulin which may result in acanthosis nigicrans, elevated insulin level or hyperglycemia.

the determination of the insulin resistance (cells inability to respond to insulin) in a biological specimen.

a cluster of closely related metabolic abnormalities associated with insulin resistance that confer an increased risk of the development of type 2 diabetes and cardiovascular disease. these abnormalities may include obesity, high blood pressure, abnormal cholesterol levels, proteinuria, and/or polycystic ovary syndrome.

insulin resistance associated with obesity, which may be attributed in part to impaired insulin signaling in target tissues, or impaired insulin-stimulated glucose transport due to reduced expression of the glucose transporter protein 4.

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.

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

This code was replaced in the 2026 ICD-10-CM code set with the code(s) listed below. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2025. This code was replaced for the FY 2026 (October 1, 2025 - September 30, 2026).

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

References found for this diagnosis code in the External Cause of Injuries Index:

The Medicare Code Editor (MCE) detects errors and inconsistencies in ICD-10-CM diagnosis coding that can affect Medicare claim validity. These Medicare code edits help medical coders and billing professionals determine when a diagnosis code is not appropriate as a principal diagnosis, does not meet coverage criteria. Use this list to verify whether a code is valid for Medicare billing and to avoid claim rejections or denials due to diagnosis coding issues.

Some diagnoses are not usually sufficient justification for admission to an acute care hospital. For example, if a patient is given code R030 for elevated blood pressure reading, without diagnosis of hypertension, then the patient would have a questionable admission, since elevated blood pressure reading is not normally sufficient justification for admission to a hospital. The following list contains diagnosis codes identified as questionable admission when used.

Below are the ICD-9 codes that most closely match this ICD-10 code, based on the General Equivalence Mappings (GEMs). This ICD-10 to ICD-9 crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.

ICD-9-CM: 250.00

Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.

When code E11.9 is part of the patient's diagnoses the following Quality Measures apply and affect reimbursement. The objective of Medicare's Quality Measures is to improve patient care by making it more: effective, safe, efficient, patient-centered and equitable.

High Priority: YES

Measure Type: Intermediateoutcome

Submission Methods: Claims, Electronic Health Record, Cms Web Interface, Registry

Description: Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period.

Diabetes Type 2

What is type 2 diabetes?

Type 2 diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your main source of energy. It comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy. If you have diabetes, your body doesn't make enough insulin or doesn't use insulin well. The glucose then stays in your blood and not enough goes into your cells.

Over time, having too much glucose in your blood can cause health problems. But you can take steps to manage your diabetes and try to prevent these health problems.

What causes type 2 diabetes?

Type 2 diabetes may be caused by a combination of factors:

Type 2 diabetes usually starts with insulin resistance. This is a condition in which your cells don't respond normally to insulin. As a result, your body needs more insulin to help the glucose enter your cells. At first, your body makes more insulin to try to get cells to respond. But over time, your body can't make enough insulin, and your blood glucose levels rise.

Who is at risk for type 2 diabetes?

You are at higher risk of developing type 2 diabetes if you:

What are the symptoms of type 2 diabetes?

Many people with type 2 diabetes have no symptoms at all. If you do have them, the symptoms develop slowly over several years. They might be so mild that you do not notice them. The symptoms can include:

How is type 2 diabetes diagnosed?

Your health care provider will use blood tests to diagnose type 2 diabetes. The blood tests include:

What are the treatments for type 2 diabetes?

Treatment for type 2 diabetes involves managing your blood sugar levels. Many people are able to do this by living a healthy lifestyle. Some people may also need to take medicine:

Can type 2 diabetes be prevented?

You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. If you have a condition which raises your risk for type 2 diabetes, managing that condition may lower your risk of getting type 2 diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

[Learn More in MedlinePlus]

Type 2 diabetes

Type 2 diabetes is a disorder characterized by abnormally high levels of blood glucose, also called blood sugar. In this form of diabetes, the body stops using and making insulin properly. Insulin is a hormone produced in the pancreas that helps regulate blood glucose levels. Specifically, insulin controls how much glucose (a type of sugar) is passed from the blood into cells, where it is used as an energy source. When blood glucose levels are high (such as after a meal), the pancreas releases insulin to move the excess glucose into cells, which reduces the amount of glucose in the blood.

Most people who develop type 2 diabetes first have insulin resistance, a condition in which the body's cells use insulin less efficiently than normal. As insulin resistance develops, more and more insulin is needed to keep blood glucose levels in the normal range. To keep up with the increasing need, insulin-producing cells in the pancreas (called beta cells) make larger amounts of insulin. Over time, the beta cells become less able to respond to blood glucose changes, leading to an insulin shortage that prevents the body from reducing blood glucose levels effectively. Most people have some insulin resistance as they age, but inadequate exercise and excessive weight gain make it worse, greatly increasing the likelihood of developing type 2 diabetes.

Type 2 diabetes can occur at any age, but it most commonly begins in middle age or later. Signs and symptoms develop slowly over years. They include frequent urination (polyuria), excessive thirst (polydipsia), fatigue, blurred vision, tingling or loss of feeling in the hands and feet (diabetic neuropathy), sores that do not heal well, and weight loss. If blood glucose levels are not controlled through medication or diet, type 2 diabetes can cause long-lasting (chronic) health problems including heart disease and stroke; nerve damage; and damage to the kidneys, eyes, and other parts of the body.

[Learn More in MedlinePlus]

Type 2 Diabetes

Learn about the symptoms of type 2 diabetes, what causes the disease, how it’s diagnosed, and steps you can take to help prevent or delay type 2 diabetes.
[Learn More in MedlinePlus]