E09.649 Drug or chemical induced diabetes mellitus with hypoglycemia without coma

Billable ICD-10-CM code, FY2026.

Applies from E09 Drug or chemical induced diabetes mellitus

Excludes1 (never code together)

• diabetes mellitus due to underlying condition (E08.-)
• gestational diabetes (O24.4-)
• neonatal diabetes mellitus (P70.2)
• postpancreatectomy diabetes mellitus (E13.-)
• postprocedural diabetes mellitus (E13.-)
• secondary diabetes mellitus NEC (E13.-)
• type 1 diabetes mellitus (E10.-)
• type 2 diabetes mellitus (E11.-)

Code first

• poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4)

Use additional code

• code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
• code to identify control using:
• injectable non-insulin antidiabetic drugs (Z79.85)
• insulin (Z79.4)
• oral antidiabetic drugs (Z79.84)
• oral hypoglycemic drugs (Z79.84)

Applies from E09.64 Drug or chemical induced diabetes mellitus with hypoglycemia

Use additional code

• code for hypoglycemia level, if applicable (E16.A-)

Risk adjustment (HCC)

• CMS-HCC V22: HCC 18 — Diabetes with Chronic Complications
• RxHCC V08: HCC 30 — Diabetes with Complications
• ESRD V24: HCC 18

MS-DRG index

Defines the logic of DRG(s) 008 in MDC PRE.

Approximate ICD-9-CM (GEMs)

• 249.80 Secondary diabetes mellitus with other specified manifestations, not stated as uncontrolled, or unspecified (approximate)

Code annotations containing back-references to E09.649

Back-references to E09.649

• Type 1 Excludes: E16.0 Drug-induced hypoglycemia without coma ("diabetes with hypoglycemia without coma (E09.649)")

Back-references to E09

• Code First: D84.81 Immunodeficiency due to conditions classified elsewhere ("diabetes mellitus (E08-E13)")
• Type 1 Excludes: E08 Diabetes mellitus due to underlying condition ("drug or chemical induced diabetes mellitus (E09.-)")
• Type 1 Excludes: E10 Type 1 diabetes mellitus ("drug or chemical induced diabetes mellitus (E09.-)")
• Type 1 Excludes: E11 Type 2 diabetes mellitus ("drug or chemical induced diabetes mellitus (E09.-)")
• Type 1 Excludes: E13 Other specified diabetes mellitus ("drug or chemical induced diabetes mellitus (E09.-)")
• Type 1 Excludes: E74 Other disorders of carbohydrate metabolism ("diabetes mellitus (E08-E13)")
• Type 2 Excludes: E87.0 Hyperosmolality and hypernatremia ("diabetes with hyperosmolarity (E08, E09, E11, E13 with final characters .00 or .01)")
• Type 1 Excludes: E87.2 Acidosis ("diabetic acidosis - see categories E08-E10, E11, E13 with ketoacidosis")
• Type 1 Excludes: G54.5 Neuralgic amyotrophy ("neuralgic amyotrophy in diabetes mellitus (E08-E13 with .44)")
• Type 1 Excludes: G59 Mononeuropathy in diseases classified elsewhere ("diabetic mononeuropathy (E08-E13 with .41)")
• Type 1 Excludes: G63 Polyneuropathy in diseases classified elsewhere ("diabetes mellitus (E08-E13 with .42)")
• Type 1 Excludes: G99.0 Autonomic neuropathy in diseases classified elsewhere ("diabetic autonomic neuropathy (E08-E13 with .43)")
• Type 1 Excludes: H20.0 Acute and subacute iridocyclitis ("iridocyclitis, iritis, uveitis (due to) (in) diabetes mellitus (E08-E13 with .39)")
• Type 1 Excludes: I73.8 Other specified peripheral vascular diseases ("diabetic (peripheral) angiopathy (E08-E13 with .51-.52)")
• Type 1 Excludes: I79.8 Other disorders of arteries, arterioles and capillaries in diseases classified elsewhere ("diabetic (peripheral) angiopathy (E08-E13 with .51-.52)")
• Type 2 Excludes: I96 Gangrene, not elsewhere classified ("gangrene in diabetes mellitus (E08-E13 with .52)")
• Type 1 Excludes: L92.1 Necrobiosis lipoidica, not elsewhere classified ("necrobiosis lipoidica associated with diabetes mellitus (E08-E13 with .620)")
• Type 1 Excludes: L99 Other disorders of skin and subcutaneous tissue in diseases classified elsewhere ("skin disorders in diabetes (E08-E13 with .62-)")
• Type 1 Excludes: M14 Arthropathies in other diseases classified elsewhere ("diabetes mellitus (E08-E13 with .61-)")
• Type 1 Excludes: M14.6 Charcôt's joint ("Charcôt's joint in diabetes mellitus (E08-E13 with .610)")
• Type 1 Excludes: M90 Osteopathies in diseases classified elsewhere ("diabetes mellitus (E08-E13 with .69-)")
• Type 1 Excludes: N08 Glomerular disorders in diseases classified elsewhere ("diabetes (E08-E13 with .21)")
• Type 1 Excludes: N16 Renal tubulo-interstitial disorders in diseases classified elsewhere ("renal tubular degeneration in diabetes (E08-E13 with .29)")
• Type 1 Excludes: N76.82 Fournier disease of vagina and vulva ("gangrene in diabetes mellitus (E08-E13 with .52)")
• Code Also: N76.82 Fournier disease of vagina and vulva (", if applicable, diabetes mellitus (E08-E13 with .9)")
• Use Additional: O24.8 Other pre-existing diabetes mellitus in pregnancy, childbirth, and the puerperium ("from categories E08, E09 and E13 to further identify any manifestation")
• Use Additional: O24.9 Unspecified diabetes mellitus in pregnancy, childbirth and the puerperium ("from categories E08, E09 and E13 to further identify any manifestation")
• Type 1 Excludes: R40 Somnolence, stupor and coma ("somnolence, stupor and coma in diabetes (E08-E13)")
• Type 1 Excludes: R73 Elevated blood glucose level ("diabetes mellitus (E08-E13)")
• Type 1 Excludes: R73.0 Abnormal glucose ("diabetes mellitus (E08-E13)")

Diagnosis Index entries for E09.649

• Diabetes, diabetic (mellitus) (sugar) › due to drug or chemical › with › hypoglycemia

Nearby codes

• E09.63 Drug or chemical induced diabetes mellitus with oral complications
• E09.630 Drug or chemical induced diabetes mellitus with periodontal disease
• E09.638 Drug or chemical induced diabetes mellitus with other oral complications
• E09.64 Drug or chemical induced diabetes mellitus with hypoglycemia
• E09.641 Drug or chemical induced diabetes mellitus with hypoglycemia with coma
• E09.649 Drug or chemical induced diabetes mellitus with hypoglycemia without coma (this code)
• E09.65 Drug or chemical induced diabetes mellitus with hyperglycemia
• E09.69 Drug or chemical induced diabetes mellitus with other specified complication
• E09.8 Drug or chemical induced diabetes mellitus with unspecified complications
• E09.9 Drug or chemical induced diabetes mellitus without complications