E11.59: Type 2 diabetes mellitus with other circulatory complications
E11.59, type 2 diabetes mellitus with other circulatory complications, is listed as a covered diagnosis in 17 Medicare billing and coding articles that apply to 144 HCPCS Level II codes, including G0127 (Trimming of dystrophic nails, any number), J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 mg). 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 7 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 E11.59 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0127 | Trimming of dystrophic nails, any number | Special coverage instructions apply | — | 7 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 3 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 3 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 3 |
| 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 |
| C8900 | Magnetic resonance angiography with contrast, abdomen | Special coverage instructions apply | — | 3 |
| C8901 | Magnetic resonance angiography without contrast, abdomen | Special coverage instructions apply | — | 3 |
| C8902 | Magnetic resonance angiography without contrast followed by with contrast, abdomen | Special coverage instructions apply | — | 3 |
| C8909 | Magnetic resonance angiography with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 3 |
| C8910 | Magnetic resonance angiography without contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 3 |
| C8911 | Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 3 |
| C8912 | Magnetic resonance angiography with contrast, lower extremity | Special coverage instructions apply | — | 3 |
| C8913 | Magnetic resonance angiography without contrast, lower extremity | Special coverage instructions apply | — | 3 |
| C8914 | Magnetic resonance angiography without contrast followed by with contrast, lower extremity | Special coverage instructions apply | — | 3 |
| C8918 | Magnetic resonance angiography with contrast, pelvis | Special coverage instructions apply | — | 3 |
| C8919 | Magnetic resonance angiography without contrast, pelvis | Special coverage instructions apply | — | 3 |
| C8920 | Magnetic resonance angiography without contrast followed by with contrast, pelvis | Special coverage instructions apply | — | 3 |
| J3490 | Unclassified drugs | Special coverage instructions apply | — | 2 |
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 2 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 2 |
119 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing E11.59
- A57759: Billing and Coding: Routine Foot Care and Debridement of Nails (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33636, L34246
- 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)
- A57183: Billing and Coding: Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L34324
- A56476: Billing and Coding: Cardiac Radionuclide Imaging (Palmetto GBA (MAC - Part A, MAC - Part B); 13 Level II codes). LCD with the same title: L33457
- A57954: Billing and Coding: Routine Foot Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A57193: Billing and Coding: Routine Foot Care and Debridement of Nails (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33636, L34246
- 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)
- A57188: Billing and Coding: Routine Foot Care (First Coast Service Options, Inc. (MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A56805: Billing and Coding: Magnetic Resonance Angiography (MRA) (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 12 Level II codes). LCD with the same title: L33633, L34372, L34865
- 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
- A56747: Billing and Coding: Magnetic Resonance Angiography (MRA) (Wellpoint Federal (MAC - Part A, MAC - Part B); 18 Level II codes). LCD with the same title: L33633, L34372, L34865
2 more articles list E11.59.
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 E11 diagnoses (Type 2 diabetes mellitus)
- E11.51 — Type 2 diabetes mellitus with diabetic peripheral angiopathy without…
- E11.52 — Type 2 diabetes mellitus with diabetic peripheral angiopathy with…
- E11.00 — Type 2 diabetes mellitus with hyperosmolarity without nonketotic…
- E11.01 — Type 2 diabetes mellitus with hyperosmolarity with coma
- E11.10 — Type 2 diabetes mellitus with ketoacidosis without coma
- E11.11 — Type 2 diabetes mellitus with ketoacidosis with coma
- E11.21 — Type 2 diabetes mellitus with diabetic nephropathy
- E11.22 — Type 2 diabetes mellitus with diabetic chronic kidney disease
- E11.29 — Type 2 diabetes mellitus with other diabetic kidney complication
- E11.311 — Type 2 diabetes mellitus with unspecified diabetic retinopathy with…
- E11.319 — Type 2 diabetes mellitus with unspecified diabetic retinopathy…
- E11.3211 — Type 2 diabetes mellitus with mild nonproliferative diabetic…
- E11.3212 — Type 2 diabetes mellitus with mild nonproliferative diabetic…
- E11.3213 — Type 2 diabetes mellitus with mild nonproliferative diabetic…
- E11.3219 — Type 2 diabetes mellitus with mild nonproliferative diabetic…
- E11.3291 — Type 2 diabetes mellitus with mild nonproliferative diabetic…
- E11.3292 — Type 2 diabetes mellitus with mild nonproliferative diabetic…
- E11.3293 — Type 2 diabetes mellitus with mild nonproliferative diabetic…
- E11.3299 — Type 2 diabetes mellitus with mild nonproliferative diabetic…
- E11.3311 — Type 2 diabetes mellitus with moderate nonproliferative diabetic…
- E11.3312 — Type 2 diabetes mellitus with moderate nonproliferative diabetic…
- E11.3313 — Type 2 diabetes mellitus with moderate nonproliferative diabetic…
- E11.3319 — Type 2 diabetes mellitus with moderate nonproliferative diabetic…
- E11.3391 — Type 2 diabetes mellitus with moderate nonproliferative diabetic…
- E11.3392 — Type 2 diabetes mellitus with moderate nonproliferative diabetic…
- E11.3393 — Type 2 diabetes mellitus with moderate nonproliferative diabetic…
- E11.3399 — Type 2 diabetes mellitus with moderate nonproliferative diabetic…
- E11.3411 — Type 2 diabetes mellitus with severe nonproliferative diabetic…
- E11.3412 — Type 2 diabetes mellitus with severe nonproliferative diabetic…
- E11.3413 — Type 2 diabetes mellitus with severe nonproliferative diabetic…
Frequently asked questions
Does Medicare cover E11.59 (Type 2 diabetes mellitus with other circulatory…)?
Medicare covers items and services, not diagnoses. 17 Medicare billing and coding articles list E11.59 as a covered diagnosis for 144 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 E11.59?
The Level II codes from the policies most specific to this diagnosis are G0127 (Trimming of dystrophic nails, any number, 7 articles); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 3 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 3 articles); J1245 (Injection, dipyridamole, per 10 mg, 3 articles); E2103 (Non-adjunctive, non-implanted continuous glucose monitor…, 2 articles). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with E11.59?
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 E11.59?
A57759 (Billing and Coding: Routine Foot Care and Debridement of Nails); 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), and 14 more articles.
What is ICD-10-CM code E11.59?
E11.59 is the ICD-10-CM code for type 2 diabetes mellitus with other circulatory complications, in category E11 (Type 2 diabetes mellitus), chapter 4: Endocrine, nutritional and metabolic diseases.
Next steps
- Run a reimbursement report for a device billed under G0127
- Watch G0127 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0127
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