E11.638 — Type 2 diabetes mellitus with other oral complications
E11.638 is a billable, specific ICD-10-CM code for type 2 diabetes mellitus with other oral complications. It is valid for submission on a claim.
Risk adjustment
E11.638 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
E11.638 is named in 28 Medicare coverage policies — 28 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 E11.638 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 E11.638.
- Diabetes, diabetic›with›oral complication NEC
- Diabetes, diabetic›type 2›with›oral complication NEC
Related codes at this level
Codes that share E11.63. If E11.638 is not quite right, the correct code is usually one of these.
Questions about E11.638
- Is E11.638 a billable ICD-10-CM code?
- Yes. E11.638 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does E11.638 sit in the tabular list?
- Endocrine, nutritional and metabolic diseases (E00-E89), in the block Diabetes mellitus (E08-E13).