2025 ICD-10-CM code E08.22
Diabetes mellitus due to an underlying condition with diabetic chronic kidney disease.
Medical necessity for this code requires documentation demonstrating the presence of diabetes mellitus, chronic kidney disease, and an underlying condition causing both.The relationship between the three must be clearly established in the documentation.
The provider is responsible for diagnosing the underlying cause of both diabetes mellitus and chronic kidney disease, assessing the stage of the chronic kidney disease, and providing appropriate treatment and management for all conditions. This may include medication management (insulin, antihypertensives), dietary modifications (low protein), dialysis, and treatment for the underlying condition.
- Endocrine, Nutritional and Metabolic Diseases (E00-E89)
- E08 - Diabetes mellitus due to underlying conditionE08.2 - Diabetes mellitus due to underlying condition with kidney complications
In simple words: This code indicates diabetes that is caused by another health problem, and has also led to chronic kidney disease. The other health problem is the underlying reason for both the diabetes and the kidney issues. Examples of these underlying problems include cystic fibrosis, some cancers, malnutrition, pancreatitis, and Cushing's syndrome. The specific stage of the chronic kidney disease will be coded separately.
This code describes a patient with diabetes mellitus caused by an underlying condition, accompanied by diabetic chronic kidney disease.This signifies that the diabetes is secondary to another disease process, which is the root cause of both the diabetes and the chronic kidney disease.Examples of underlying conditions include cystic fibrosis, neoplasms, malnutrition, pancreatitis, and Cushing's syndrome. The stage of chronic kidney disease should be coded separately with N18.1-N18.6.
Example 1: A patient with long-standing cystic fibrosis develops diabetes and progressive kidney dysfunction. Both conditions are attributed to the underlying cystic fibrosis, thus E08.22 would be used along with a code for cystic fibrosis and the appropriate stage of chronic kidney disease., A patient receiving chemotherapy for pancreatic cancer develops diabetes and chronic kidney disease as a result of the malignancy and/or treatment. E08.22 would be used in conjunction with the code for the pancreatic cancer and the chronic kidney disease stage., A patient with poorly controlled Cushing's syndrome develops both diabetes and chronic kidney disease.The physician determines that both conditions are a result of the hormonal imbalances caused by the Cushing's syndrome.E08.22 is used, along with the code for Cushing's syndrome and the chronic kidney disease stage.
Documentation should clearly link the diabetes, the chronic kidney disease, and the underlying condition. The underlying condition should be clearly documented as the cause of both the diabetes and the kidney disease.The stage of chronic kidney disease should be documented and supported by relevant lab results and clinical findings.Documentation should also include relevant history, physical exam findings, and laboratory results, including blood glucose levels, BUN, creatinine, and urinalysis.Any treatments provided should also be documented.
** It is important to distinguish between diabetes WITH chronic kidney disease (E08.22, E09.22, E10.22, E11.22, E13.22) and chronic kidney disease WITH diabetes (N18.1-N18.6). The E codes indicate the diabetes is due to an underlying condition.The N codes indicate that the chronic kidney disease is the primary condition, whether or not there is an underlying condition causing the diabetes.If the documentation supports both, then both should be coded with the N code sequenced first.
- Payment Status: Active
- Specialties:Endocrinology, Nephrology, Internal Medicine
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Federally Qualified Health Center