What is the ICD-10 code for diabetes mellitus with diabetic nephropathy?

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: November 2, 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 Coding for Diabetes Mellitus with Diabetic Nephropathy

The ICD-10 code for diabetes mellitus with diabetic nephropathy uses the E1x.2x series, where the specific code depends on the type of diabetes and presence of complications.

Code Structure

The ICD-10 coding follows this pattern:

  • E10.2x - Type 1 diabetes mellitus with kidney complications
  • E11.2x - Type 2 diabetes mellitus with kidney complications
  • E13.2x - Other specified diabetes mellitus with kidney complications

The fifth digit further specifies the type of kidney complication:

  • E1x.21 - with diabetic nephropathy
  • E1x.22 - with diabetic chronic kidney disease
  • E1x.29 - with other diabetic kidney complication

Clinical Context for Accurate Coding

Diabetic nephropathy is diagnosed clinically based on persistent albuminuria and/or reduced eGFR in the absence of other primary kidney disease 1. The diagnosis typically requires:

  • Persistent albuminuria (≥30 mg/g creatinine on at least 2 of 3 specimens collected over 3-6 months) 2, 3
  • Reduced eGFR (<60 mL/min/1.73 m²) 1
  • Duration of diabetes >5 years (for type 1 diabetes) 1
  • Presence of other diabetic complications (particularly retinopathy) 1

Additional Coding Considerations

When chronic kidney disease is present, use an additional code from N18.- to specify the CKD stage 4. For example:

  • N18.1 - Chronic kidney disease, stage 1
  • N18.2 - Chronic kidney disease, stage 2
  • N18.3 - Chronic kidney disease, stage 3
  • N18.4 - Chronic kidney disease, stage 4
  • N18.5 - Chronic kidney disease, stage 5

For patients on renal replacement therapy, add:

  • Z94.0 - Kidney transplant status
  • Z99.2 - Dependence on renal dialysis

Validation Data

Recent validation studies demonstrate that ICD-10 codes for diabetic nephropathy (E1x.2) have a positive predictive value of 96.6% when documented in routine health insurance data 4. The code N08.3 (glomerular disorders in diseases classified elsewhere, specifically diabetic nephropathy) can also be used but is less commonly employed in primary coding.

Common Pitfalls

  • Do not code diabetic nephropathy based on a single elevated albumin measurement - requires persistence over 3-6 months 2, 3
  • Consider alternative diagnoses if presentation is atypical (rapid progression, absence of retinopathy in type 1 diabetes, extreme proteinuria >6 g/day, active urinary sediment) 1
  • Document both the diabetes code with nephropathy (E1x.2x) AND the CKD stage (N18.x) for complete coding 4

References

Related Questions

How much protein should a 212‑lb (≈96 kg) adult consume per day?
What is the recommended daily protein intake for a 106‑kg, 185‑cm adult who is trying to lose weight?
What are the possible causes and recommended work‑up for low protein concentration in cerebrospinal fluid?
Do 73‑year‑old individuals have a reduced capacity to utilize ingested protein for muscle protein synthesis, and if so, what is the approximate percentage reduction and the recommended protein intake in grams per kilogram of body weight?
Which ICD‑10 diagnosis codes should be used to justify ordering the laboratory panel that includes TSH, free T4, lipid panel, comprehensive metabolic panel, hemoglobin A1c, vitamin B12, free T3, vitamin D 25‑OH, and CBC with differential?
What intravenous antibiotic regimen should be used to treat multifocal pneumonia in an adult patient without multidrug‑resistant risk factors?
Why is UNASYN (ampicillin‑sulbactam) compatible with Lactated Ringer’s as a diluent but not compatible for Y‑site administration?
What conditions other than hereditary hemochromatosis can cause transferrin saturation above 48%, serum iron above 200 µg/dL, normal or low ferritin, and macrocytosis (mean corpuscular volume >95 fL) despite 1.5 years of regular blood donation?
Where is the tip of a temporary transvenous pacemaker placed?
Should a patient on tamoxifen with depression and irritability, for whom weight loss is not a concern, increase vortioxetine to 15‑20 mg daily or switch to bupropion?
What is the appropriate amoxicillin oral suspension dose for an 11-year-old child weighing 44.3 kg with acute otitis media?

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.