E09.37X9: Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
E09.37X9, drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 112 HCPCS Level II codes, including E2103 (Non-adjunctive, non-implanted continuous glucose monitor…), A4239 (Supply allowance for non-adjunctive, non-implanted…), A4238 (Supply allowance for adjunctive, non-implanted continuous…). 54 of these codes have a 2026 DMEPOS fee schedule amount; E2103 pays $256.09 to $334.44 (NU) depending on the state. The articles come from 3 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 E09.37X9 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| E2103 | Non-adjunctive, non-implanted continuous glucose monitor or receiver | Carrier judgment | $256.09–$334.44 (NU) | 2 |
| A4239 | Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service | Carrier judgment | $273.28 | 2 |
| A4238 | Supply allowance for adjunctive, non-implanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service | Carrier judgment | $280.71 (KF) | 2 |
| E2102 | Adjunctive, non-implanted continuous glucose monitor or receiver | Carrier judgment | $189.08–$239.22 (NU) | 2 |
| E1399 | Durable medical equipment, miscellaneous | Carrier judgment | — | 2 |
| A9999 | Miscellaneous dme supply or accessory, not otherwise specified | Carrier judgment | — | 2 |
| G0127 | Trimming of dystrophic nails, any number | Special coverage instructions apply | — | 2 |
| G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0300 | Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| L5000 | Partial foot, shoe insert with longitudinal arch, toe filler | Special coverage instructions apply | $618.56–$999.36 | 1 |
| A5501 | For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe | Special coverage instructions apply | $271.80 | 1 |
| L3224 | Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis) | Special coverage instructions apply | $67.57–$152.32 | 1 |
| L3225 | Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis) | Special coverage instructions apply | $77.73–$140.82 | 1 |
| A5500 | For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe | Special coverage instructions apply | $90.63 | 1 |
| A5514 | For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each | Special coverage instructions apply | $55.16 | 1 |
| A5513 | For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each | Special coverage instructions apply | $55.16 | 1 |
| A5503 | For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe | Special coverage instructions apply | $45.79 | 1 |
| A5504 | For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe | Special coverage instructions apply | $45.79 | 1 |
| A5507 | For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe | Special coverage instructions apply | $45.79 | 1 |
| A5505 | For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe | Special coverage instructions apply | $45.79 | 1 |
| A5506 | For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe | Special coverage instructions apply | $45.79 | 1 |
| A5512 | For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each | Special coverage instructions apply | $36.96 | 1 |
| L5999 | Lower extremity prosthesis, not otherwise specified | Carrier judgment | — | 1 |
| A5508 | For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe | Special coverage instructions apply | — | 1 |
| A5510 | For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe | Special coverage instructions apply | — | 1 |
87 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing E09.37X9
- A56674: Billing and Coding: Home Health Plans of Care: Monitoring Glucose Control in the Medicare Home Health Population with Type II Diabetes Mellitus (Palmetto GBA (HHH MAC); 2 Level II codes). LCD with the same title: L35132
- 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)
- 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 E09 diagnoses (Drug or chemical induced diabetes mellitus)
- E09.37X1 — Drug or chemical induced diabetes mellitus with diabetic macular…
- E09.37X2 — Drug or chemical induced diabetes mellitus with diabetic macular…
- E09.37X3 — Drug or chemical induced diabetes mellitus with diabetic macular…
- E09.311 — Drug or chemical induced diabetes mellitus with unspecified diabetic…
- E09.319 — Drug or chemical induced diabetes mellitus with unspecified diabetic…
- E09.3211 — Drug or chemical induced diabetes mellitus with mild…
- E09.3212 — Drug or chemical induced diabetes mellitus with mild…
- E09.3213 — Drug or chemical induced diabetes mellitus with mild…
- E09.3219 — Drug or chemical induced diabetes mellitus with mild…
- E09.3291 — Drug or chemical induced diabetes mellitus with mild…
- E09.3292 — Drug or chemical induced diabetes mellitus with mild…
- E09.3293 — Drug or chemical induced diabetes mellitus with mild…
- E09.3299 — Drug or chemical induced diabetes mellitus with mild…
- E09.3311 — Drug or chemical induced diabetes mellitus with moderate…
- E09.3312 — Drug or chemical induced diabetes mellitus with moderate…
- E09.3313 — Drug or chemical induced diabetes mellitus with moderate…
- E09.3319 — Drug or chemical induced diabetes mellitus with moderate…
- E09.3391 — Drug or chemical induced diabetes mellitus with moderate…
- E09.3392 — Drug or chemical induced diabetes mellitus with moderate…
- E09.3393 — Drug or chemical induced diabetes mellitus with moderate…
- E09.3399 — Drug or chemical induced diabetes mellitus with moderate…
- E09.3411 — Drug or chemical induced diabetes mellitus with severe…
- E09.3412 — Drug or chemical induced diabetes mellitus with severe…
- E09.3413 — Drug or chemical induced diabetes mellitus with severe…
- E09.3419 — Drug or chemical induced diabetes mellitus with severe…
- E09.3491 — Drug or chemical induced diabetes mellitus with severe…
- E09.3492 — Drug or chemical induced diabetes mellitus with severe…
- E09.3493 — Drug or chemical induced diabetes mellitus with severe…
- E09.3499 — Drug or chemical induced diabetes mellitus with severe…
- E09.3511 — Drug or chemical induced diabetes mellitus with proliferative…
Frequently asked questions
Does Medicare cover E09.37X9 (Drug or chemical induced diabetes mellitus with diabetic…)?
Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list E09.37X9 as a covered diagnosis for 112 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 E09.37X9?
The Level II codes from the policies most specific to this diagnosis are E2103 (Non-adjunctive, non-implanted continuous glucose monitor…, 2 articles); A4239 (Supply allowance for non-adjunctive, non-implanted…, 2 articles); A4238 (Supply allowance for adjunctive, non-implanted continuous…, 2 articles); E2102 (Adjunctive, non-implanted continuous glucose monitor or…, 2 articles); E1399 (Durable medical equipment, miscellaneous, 2 articles). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with E09.37X9?
Under the 2026 DMEPOS fee schedule (non-rural state fees): E2103 $256.09 to $334.44 (NU); A4239 $273.28; A4238 $280.71 (KF); E2102 $189.08 to $239.22 (NU). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list E09.37X9?
A56674 (Billing and Coding: Home Health Plans of Care: Monitoring Glucose Control in the Medicare Home Health Population with Type II Diabetes Mellitus); A52501 (Therapeutic Shoes for Persons with Diabetes - Policy Article); A52507 (External Infusion Pumps - Policy Article), and 3 more articles.
What is ICD-10-CM code E09.37X9?
E09.37X9 is the ICD-10-CM code for drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye, in category E09 (Drug or chemical induced diabetes mellitus), chapter 4: Endocrine, nutritional and metabolic diseases.
Next steps
- Run a reimbursement report for a device billed under E2103
- Watch E2103 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E2103
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