E11.21 — Type 2 diabetes mellitus with diabetic nephropathy
E11.21 is a billable, specific ICD-10-CM code for type 2 diabetes mellitus with diabetic nephropathy. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Type 2 diabetes mellitus with intercapillary glomerulosclerosis
- Type 2 diabetes mellitus with intracapillary glomerulonephrosis
- Type 2 diabetes mellitus with Kimmelstiel-Wilson disease
Risk adjustment
E11.21 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 37 Diabetes with Chronic Complications0.166 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
E11.21 is named in 39 Medicare coverage policies — 39 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52464Glucose Monitor - Policy Article
- A52501Therapeutic Shoes for Persons with Diabetes - Policy Article
- A52507External Infusion Pumps - Policy Article
- A52996Billing and Coding: Routine Foot Care
How E11.21 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to E11.21.
- Diabetes, diabetic›with›glomerulonephrosis, intracapillary
- Diabetes, diabetic›with›glomerulosclerosis, intercapillary
- Diabetes, diabetic›with›Kimmelstiel-Wilson disease
- Diabetes, diabetic›with›nephropathy
- Diabetes, diabetic›type 2›with›glomerulonephrosis, intracapillary
- Diabetes, diabetic›type 2›with›glomerulosclerosis, intercapillary
- Diabetes, diabetic›type 2›with›Kimmelstiel-Wilson disease
- Diabetes, diabetic›type 2›with›nephropathy
Related codes at this level
Codes that share E11.2. If E11.21 is not quite right, the correct code is usually one of these.
Questions about E11.21
- Is E11.21 a billable ICD-10-CM code?
- Yes. E11.21 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does E11.21 sit in the tabular list?
- Endocrine, nutritional and metabolic diseases (E00-E89), in the block Diabetes mellitus (E08-E13).