As of October 1, 2025, ICD-10-CM introduced a new code—E11.A (Type 2 diabetes mellitus in remission)—bringing a major shift in how coders capture improved patient outcomes.
This update recognizes that type 2 diabetes can go into remission, and it allows providers and coders to accurately reflect that success in medical records.
What is Code E11.A?
E11.A is used for patients who:
- Have a history of type 2 diabetes
- Have achieved remission
- Maintain A1C < 6.5% for at least 3 months
- Are not taking any diabetes medications
- Have no active diabetic complications
👉 This code helps differentiate between:
- Controlled diabetes (still active, managed with medication)
- Diabetes in remission (no longer requiring medication)
Documentation Requirements for E11.A
To correctly assign E11.A, provider documentation must clearly support remission.
Required Elements:
- ✔ Explicit documentation of the term “remission”
- ✔ Evidence of A1C < 6.5% for at least 3 consecutive months
- ✔ Confirmation of no current diabetes medications
- ✔ No ongoing diabetic complications
Acceptable Causes of Remission
Documentation should also explain how remission was achieved, such as:
- Lifestyle changes (diet and exercise)
- Significant weight loss
- Bariatric surgery
- Medically supervised weight loss programs
When NOT to Use E11.A
Avoid assigning E11.A in the following cases:
❌ Type 1 Diabetes
This code applies only to type 2 diabetes
❌ Presence of Complications
If the patient still has:
- Neuropathy
- Nephropathy
- Retinopathy
👉 Use appropriate E11.- complication codes instead
❌ “Resolved” Diabetes
ICD-10-CM guidelines are clear:
- The term “resolved” ≠ remission
👉 In these cases, assign:
- Z86.39 – Personal history of endocrine/metabolic disease
Why This Code Matters for Medical Coders
The introduction of E11.A improves:
1. Coding Accuracy
Captures true patient status instead of defaulting to active diabetes
2. Clinical Data Quality
Supports better tracking of:
- Treatment outcomes
- Population health trends
- Disease reversal success
3. Patient Care
Ensures patients in remission still receive:
- Ongoing monitoring
- Preventive care
- Lifestyle counseling
Important Coding Tip
Even if diabetes is in remission:
👉 Patients still require:
- Regular A1C monitoring
- Blood pressure checks
- Lifestyle follow-up
✔ Remission does not mean discharge from care
Common Coding Mistakes to Avoid
- ❌ Using E11.A without documentation of “remission”
- ❌ Assigning E11.A when patient is still on medication
- ❌ Ignoring existing complications
- ❌ Confusing “resolved” with “remission”
Pro Tips for Medical Coders
- Always verify provider documentation
- Look for clinical evidence (A1C values)
- Confirm medication status
- Query provider if remission is unclear
- Apply Z86.39 correctly when appropriate
Conclusion
The addition of ICD-10-CM code E11.A is a significant step forward in capturing diabetes remission. For medical coders, understanding when and how to use this code is essential for accurate reporting, compliance, and supporting improved patient outcomes.
