E11.69: Type 2 diabetes mellitus with other specified complication

E11.69, type 2 diabetes mellitus with other specified complication, is listed as a covered diagnosis in 12 Medicare billing and coding articles that apply to 143 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 5 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 E11.69 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
E0776Iv poleCarrier judgment$173.42–$194.69 (NU)1
B4152Enteral 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 unitSpecial coverage instructions apply—1
B4150Enteral 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 unitSpecial coverage instructions apply—1
B4154Enteral 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 unitSpecial coverage instructions apply—1
B4153Enteral 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 unitSpecial coverage instructions apply—1
B4035Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tapeSpecial coverage instructions apply—1
B4034Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tapeSpecial coverage instructions apply—1
B4149Enteral 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 unitSpecial coverage instructions apply—1
B4155Enteral 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 unitSpecial coverage instructions apply—1
B4036Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tapeSpecial coverage instructions apply—1
B4161Enteral 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 unitSpecial coverage instructions apply—1
B4160Enteral 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 unitSpecial coverage instructions apply—1
B9002Enteral nutrition infusion pump, any typeSpecial coverage instructions apply—1
B4157Enteral 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 unitSpecial coverage instructions apply—1
B4105In-line cartridge containing digestive enzyme(s) for enteral feeding, eachCarrier judgment—1
B4162Enteral 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 unitSpecial coverage instructions apply—1
B4159Enteral 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 unitSpecial coverage instructions apply—1
B4158Enteral 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 unitSpecial coverage instructions apply—1
B4102Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unitSpecial coverage instructions apply—1
B4103Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unitSpecial coverage instructions apply—1
B4104Additive for enteral formula (e.g., fiber)Special coverage instructions apply—1
B4148Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tapeSpecial coverage instructions apply—1
B9998Noc for enteral suppliesSpecial coverage instructions apply—1
G0127Trimming of dystrophic nails, any numberSpecial coverage instructions apply—4
E2103Non-adjunctive, non-implanted continuous glucose monitor or receiverCarrier judgment$256.09–$334.44 (NU)2

118 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing E11.69

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)

Frequently asked questions

Does Medicare cover E11.69 (Type 2 diabetes mellitus with other specified complication)?

Medicare covers items and services, not diagnoses. 12 Medicare billing and coding articles list E11.69 as a covered diagnosis for 143 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 E11.69?

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 E11.69?

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 E11.69?

A58833 (Enteral Nutrition - Policy Article); A56674 (Billing and Coding: Home Health Plans of Care: Monitoring Glucose Control in the Medicare Home Health Population with Type II Diabetes Mellitus); A56686 (Billing and Coding: HbA1c), and 9 more articles.

What is ICD-10-CM code E11.69?

E11.69 is the ICD-10-CM code for type 2 diabetes mellitus with other specified complication, in category E11 (Type 2 diabetes mellitus), chapter 4: Endocrine, nutritional and metabolic diseases.

Next steps

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