What ICD-10 codes correspond to obesity, type 2 diabetes mellitus, hypertension, and hyperlipidemia?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: July 29, 2026 • View editorial policy

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question

ICD-10 Codes for Obesity, Type 2 Diabetes Mellitus, Hypertension, and Hyperlipidemia

Use E66.x for obesity, E11.x for type 2 diabetes mellitus, I10 for essential hypertension, and E78.x for hyperlipidemia—these codes have been validated with high specificity (>95%) and positive predictive values (>85%) in administrative databases.

Specific ICD-10 Code Recommendations

Obesity (E66.x)

  • E66.9: Obesity, unspecified (most commonly used)
  • E66.01: Morbid (severe) obesity due to excess calories (BMI ≥40 kg/m²)
  • E66.09: Other obesity due to excess calories (BMI 30-39.9 kg/m²)
  • E66.3: Overweight (BMI 25-29.9 kg/m²)

The E66 code series demonstrates 87.6% positive predictive value when validated against documented BMI measurements 1. Specificity is excellent at 97.0% for BMI ≥25 kg/m² and 98.2% for BMI ≥30 kg/m² 2. However, be aware that sensitivity is low (<40%), meaning obesity is significantly underreported in administrative data—only 10.9% of patients with documented BMI ≥25 kg/m² receive an obesity diagnosis code 1.

Type 2 Diabetes Mellitus (E11.x)

  • E11.9: Type 2 diabetes mellitus without complications (baseline code)
  • E11.65: Type 2 diabetes mellitus with hyperglycemia
  • E11.22: Type 2 diabetes mellitus with diabetic chronic kidney disease
  • E11.36: Type 2 diabetes mellitus with diabetic cataract
  • E11.40: Type 2 diabetes mellitus with diabetic neuropathy, unspecified
  • E11.51: Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
  • E11.59: Type 2 diabetes mellitus with other circulatory complications
  • E11.319: Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema

The algorithm "2 physician claims within 2 years OR 1 hospitalization" with E11.x codes achieves 92.3% sensitivity and 96.9% specificity 3. For youth-onset diabetes, ICD-10-CM codes discriminate type 2 from type 1 diabetes with 90.6% sensitivity and 96.3% specificity 4.

Type 2 diabetes accounts for 90-95% of all diabetes cases and is strongly associated with obesity, hypertension, and dyslipidemia 5. When coding, select the most specific code that captures documented complications.

Hypertension (I10-I16)

  • I10: Essential (primary) hypertension (use this for uncomplicated hypertension)
  • I11.0: Hypertensive heart disease with heart failure
  • I11.9: Hypertensive heart disease without heart failure
  • I12.0: Hypertensive chronic kidney disease with stage 5 CKD or ESRD
  • I12.9: Hypertensive chronic kidney disease with stage 1-4 CKD
  • I13.x: Hypertensive heart and chronic kidney disease (use when both present)

For hypertensive disorders during pregnancy, ICD-10 codes demonstrate >90% positive predictive value, negative predictive value, and specificity 6. The I10 code is straightforward for essential hypertension, which commonly coexists with type 2 diabetes—the 2025 AHA/ACC guidelines emphasize that hypertension management in diabetes should target SBP <120 mm Hg for improved cardiovascular outcomes 7.

Hyperlipidemia (E78.x)

  • E78.5: Hyperlipidemia, unspecified (most general code)
  • E78.0: Pure hypercholesterolemia
  • E78.1: Pure hypertriglyceridemia
  • E78.2: Mixed hyperlipidemia (elevated cholesterol AND triglycerides)
  • E78.00: Pure hypercholesterolemia, unspecified
  • E78.01: Familial hypercholesterolemia

E78.2 (mixed hyperlipidemia) is particularly relevant when both cholesterol and triglycerides are elevated, which frequently occurs in metabolic syndrome alongside obesity, diabetes, and hypertension 7.

Clinical Context and Coding Pitfalls

Common Clustering Pattern

These four conditions frequently coexist as part of metabolic syndrome or cardiovascular-kidney-metabolic (CKM) syndrome 7. 27.79% of type 2 diabetic patients have both hypertension and hyperlipidemia together, with an additional 28.34% having hypertension alone and 20.53% having hyperlipidemia alone 8.

Key Coding Considerations

  • Specificity over sensitivity: While obesity codes have high specificity (>95%), they capture only about 11% of patients with documented obesity 1, 2. This means you can trust a positive code, but absence of a code doesn't rule out obesity.

  • Diabetes complications: Always code to the highest level of specificity. If diabetic retinopathy, nephropathy, or neuropathy is documented, use the appropriate E11.x subcategory rather than E11.9.

  • Hypertension in diabetes: The 2025 guidelines emphasize intensive BP control (SBP <120 mm Hg) for patients ≥50 years with type 2 diabetes 7. Document whether hypertension is controlled or uncontrolled when relevant.

  • Metabolic syndrome documentation: When all four conditions coexist, consider documenting this as metabolic syndrome, which affects 47% of U.S. adults and carries increased CVD risk 7.

Validation Data Summary

The ICD-10 codes for these conditions have been rigorously validated:

  • Obesity (E66.x): PPV 87.6%, specificity 97-99% 1, 2
  • Type 2 diabetes (E11.x): Sensitivity 92.3%, specificity 96.9% 3
  • Hypertension (I10): PPV, NPV, specificity >90% 6
  • Hyperlipidemia (E78.x): High validity when part of metabolic syndrome cluster 7

References

2
Research

Validation of obesity-related diagnosis codes in claims data.

Diabetes, obesity & metabolism, 2021

Related Questions

For a patient weighing 208.8 lb, height 66 in, with a BMI of 33.7, what is the appropriate ICD‑10‑CM code and description for her weight category?
Which ICD‑10‑CM diagnosis codes qualify for insurance coverage of Dexcom G7 continuous glucose monitor sensors and receiver?
What ICD‑10 code should be used for an adult BMI of 38.5?
What ICD‑10‑CM codes correspond to an adult patient with type 2 diabetes mellitus, elevated vitamin B12, hyperlipidemia, and who is taking low‑dose aspirin, ergocalciferol, fish‑oil supplement, glimepiride, a lisinopril/hydrochlorothiazide combination, metoprolol tartrate, and nifedipine?
What is the ICD‑10‑CM code for tinea pedis in a diabetic patient, and which code should be used for the underlying diabetes mellitus?
When the polyethylene glycol (PEG) precipitation test cannot be performed, which laboratory tests should be used to evaluate vitamin B12 status?
What is the expected Tanner stage for an 11-year-old boy?
Can apixaban 10 mg twice daily be used to treat pulmonary embolism after completing 10 days of therapeutic‑dose enoxaparin?
I notice red-colored stool (possible hematochezia) only after eating red meat, with otherwise normal stools—could this be true gastrointestinal bleeding, and what diagnostic steps should I take?
What defines a severe mechanism of injury for head trauma?
What laboratory tests can be used to evaluate macro‑vitamin B12 when polyethylene glycol (PEG) precipitation and holotranscobalamin (holoTC) assays are unavailable?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.