E08.69: Diabetes mellitus due to underlying condition with other specified complication
E08.69, diabetes mellitus due to underlying condition with other specified complication, is listed as a covered diagnosis in 8 Medicare billing and coding articles that apply to 135 HCPCS Level II codes, including E0776 (Iv pole), B4152 (Enteral formula, nutritionally complete, calorically dense…), B4150 (Enteral formula, nutritionally complete with intact…). 55 of these codes have a 2026 DMEPOS fee schedule amount; E0776 pays $173.42 to $194.69 (NU) depending on the state. The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with E08.69 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| E0776 | Iv pole | Carrier judgment | $173.42–$194.69 (NU) | 1 |
| B4152 | Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | Special coverage instructions apply | — | 1 |
| B4150 | Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | Special coverage instructions apply | — | 1 |
| B4154 | Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | Special coverage instructions apply | — | 1 |
| B4153 | Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | Special coverage instructions apply | — | 1 |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | Special coverage instructions apply | — | 1 |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | Special coverage instructions apply | — | 1 |
| B4149 | Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | Special coverage instructions apply | — | 1 |
| B4155 | Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit | Special coverage instructions apply | — | 1 |
| B4036 | Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | Special coverage instructions apply | — | 1 |
| B4161 | Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | Special coverage instructions apply | — | 1 |
| B4160 | Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | Special coverage instructions apply | — | 1 |
| B9002 | Enteral nutrition infusion pump, any type | Special coverage instructions apply | — | 1 |
| B4157 | Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | Special coverage instructions apply | — | 1 |
| B4105 | In-line cartridge containing digestive enzyme(s) for enteral feeding, each | Carrier judgment | — | 1 |
| B4162 | Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | Special coverage instructions apply | — | 1 |
| B4159 | Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit | Special coverage instructions apply | — | 1 |
| B4158 | Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit | Special coverage instructions apply | — | 1 |
| B4102 | Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit | Special coverage instructions apply | — | 1 |
| B4103 | Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit | Special coverage instructions apply | — | 1 |
| B4104 | Additive for enteral formula (e.g., fiber) | Special coverage instructions apply | — | 1 |
| B4148 | Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | Special coverage instructions apply | — | 1 |
| B9998 | Noc for enteral supplies | Special coverage instructions apply | — | 1 |
| G0127 | Trimming of dystrophic nails, any number | Special coverage instructions apply | — | 3 |
| E2103 | Non-adjunctive, non-implanted continuous glucose monitor or receiver | Carrier judgment | $256.09–$334.44 (NU) | 2 |
110 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing E08.69
- A58833: Enteral Nutrition - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 25 Level II codes). LCD with the same title: L38955
- A56686: Billing and Coding: HbA1c (Palmetto GBA (MAC - Part B); 1 Level II codes). LCD with the same title: L33431
- A52501: Therapeutic Shoes for Persons with Diabetes - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 28 Level II codes). LCD with the same title: L33369
- A52507: External Infusion Pumps - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 55 Level II codes). LCD with the same title: L33794
- A52464: Glucose Monitor - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 33 Level II codes)
- A52996: Billing and Coding: Routine Foot Care (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A56232: Billing and Coding: Foot Care (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes)
- A56680: Billing and Coding: Routine Foot Care (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other E08 diagnoses (Diabetes mellitus due to underlying condition)
- E08.610 — Diabetes mellitus due to underlying condition with diabetic…
- E08.618 — Diabetes mellitus due to underlying condition with other diabetic…
- E08.620 — Diabetes mellitus due to underlying condition with diabetic dermatitis
- E08.621 — Diabetes mellitus due to underlying condition with foot ulcer
- E08.622 — Diabetes mellitus due to underlying condition with other skin ulcer
- E08.628 — Diabetes mellitus due to underlying condition with other skin…
- E08.630 — Diabetes mellitus due to underlying condition with periodontal disease
- E08.638 — Diabetes mellitus due to underlying condition with other oral…
- E08.641 — Diabetes mellitus due to underlying condition with hypoglycemia with…
- E08.649 — Diabetes mellitus due to underlying condition with hypoglycemia…
- E08.65 — Diabetes mellitus due to underlying condition with hyperglycemia
- E08.00 — Diabetes mellitus due to underlying condition with hyperosmolarity…
- E08.01 — Diabetes mellitus due to underlying condition with hyperosmolarity…
- E08.10 — Diabetes mellitus due to underlying condition with ketoacidosis…
- E08.11 — Diabetes mellitus due to underlying condition with ketoacidosis with…
- E08.21 — Diabetes mellitus due to underlying condition with diabetic…
- E08.22 — Diabetes mellitus due to underlying condition with diabetic chronic…
- E08.29 — Diabetes mellitus due to underlying condition with other diabetic…
- E08.311 — Diabetes mellitus due to underlying condition with unspecified…
- E08.319 — Diabetes mellitus due to underlying condition with unspecified…
- E08.3211 — Diabetes mellitus due to underlying condition with mild…
- E08.3212 — Diabetes mellitus due to underlying condition with mild…
- E08.3213 — Diabetes mellitus due to underlying condition with mild…
- E08.3219 — Diabetes mellitus due to underlying condition with mild…
- E08.3291 — Diabetes mellitus due to underlying condition with mild…
- E08.3292 — Diabetes mellitus due to underlying condition with mild…
- E08.3293 — Diabetes mellitus due to underlying condition with mild…
- E08.3299 — Diabetes mellitus due to underlying condition with mild…
- E08.3311 — Diabetes mellitus due to underlying condition with moderate…
- E08.3312 — Diabetes mellitus due to underlying condition with moderate…
Frequently asked questions
Does Medicare cover E08.69 (Diabetes mellitus due to underlying condition with other…)?
Medicare covers items and services, not diagnoses. 8 Medicare billing and coding articles list E08.69 as a covered diagnosis for 135 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 E08.69?
The Level II codes from the policies most specific to this diagnosis are E0776 (Iv pole, 1 article); B4152 (Enteral formula, nutritionally complete, calorically dense…, 1 article); B4150 (Enteral formula, nutritionally complete with intact…, 1 article); B4154 (Enteral formula, nutritionally complete, for special…, 1 article); B4153 (Enteral formula, nutritionally complete, hydrolyzed…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with E08.69?
Under the 2026 DMEPOS fee schedule (non-rural state fees): E0776 $173.42 to $194.69 (NU); E2103 $256.09 to $334.44 (NU); A4239 $273.28; A4238 $280.71 (KF). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list E08.69?
A58833 (Enteral Nutrition - Policy Article); A56686 (Billing and Coding: HbA1c); A52501 (Therapeutic Shoes for Persons with Diabetes - Policy Article), and 5 more articles.
What is ICD-10-CM code E08.69?
E08.69 is the ICD-10-CM code for diabetes mellitus due to underlying condition with other specified complication, in category E08 (Diabetes mellitus due to underlying condition), chapter 4: Endocrine, nutritional and metabolic diseases.
Next steps
- Run a reimbursement report for a device billed under E0776
- Watch E0776 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E0776
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 4: Endocrine, nutritional and metabolic diseases · All diagnoses · HCPCS lookup