ICD-10 Code E09.21 – Drug or chemical induced diabetes mellitus with diabetic nephropathy (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code E09.21 – Drug or chemical induced diabetes mellitus with diabetic nephropathy
What it is
This code identifies diabetes caused by a drug or chemical, with kidney involvement documented as diabetic nephropathy. Use it when the record links the diabetes and the nephropathy to the same drug or chemical exposure.
Clinical signs
Clinical features vary; refer to documentation. You may see evidence of diabetes plus kidney disease described as nephropathy, proteinuria, or diabetic renal complications in the context of a causative medication or chemical.
When to use this code
Use E09.21 when the provider states that diabetes is drug or chemical induced and also documents diabetic nephropathy. The causal agent should be identified in the chart when possible. If the nephropathy is not specified, or the diabetes cause is unclear, check documentation.
Do not use for
Do not use this code for type 1, type 2, or gestational diabetes. Also avoid it when kidney disease is present but not documented as diabetic nephropathy or not linked to a drug or chemical cause.
Coding tip
Code the adverse drug or chemical cause separately when the record supports it, and verify that nephropathy is explicitly documented.