E13.641 Other specified diabetes mellitus with hypoglycemia with coma

ICD-10-CM E13.641: Other specified diabetes mellitus with hypoglycemia with coma

ICD-10-CM code E13.641 represents other specified diabetes mellitus with hypoglycemia with coma. This diagnosis sits within the endocrine, nutritional, and metabolic diseases chapter. The code identifies a severe and potentially fatal acute complication. Documentation must clearly indicate both hypoglycemia and coma are present to use this specific code. 5 4

Plain-language overview

Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia that can cause damage to various organ systems. Hypoglycemia is frequently observed in patients with diabetes mellitus and is defined as a venous blood glucose level under 55mg/dl. 1 2

What this code represents

E13.641 is the ICD-10-CM diagnosis code for other specified diabetes mellitus with hypoglycemia with coma. This code identifies hypoglycemia with coma in other specified diabetes mellitus, representing a severe and potentially fatal acute complication. 5

Coding details

E13.641 is a billable diagnosis code that sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases, within the section covering diabetes mellitus. ICD-10-CM does not list inclusion terms for E13.641 in this effective period. 5

The ICD-10-CM manual distinguishes other specified diabetes mellitus with hypoglycemia with coma from other specified diabetes mellitus with hypoglycemia without coma. If only hypoglycemia without coma exists, use E13.641 without the coma component instead. 3 5

Documentation considerations

Documentation must clearly indicate both hypoglycemia and coma are present to assign E13.641. A workup for hypoglycemia is initiated if the patient fulfills Whipple’s triad, which includes biochemical evidence of hypoglycemia and clinical signs consistent with hypoglycemia. 5 2

Coverage and utilization context

Under the CMS-HCC V28 risk adjustment model, E13.641 maps to Diabetes with Severe Acute Complications (HCC 36) with a community, non-dual, aged base RAF weight of 0.166. Under the older CMS-HCC V24 model, it maps to Diabetes with Acute Complications (HCC 17) with a RAF weight of 0.302. 5

What the sources add

The CMS coverage database lists E13.641 as other specified diabetes mellitus with hypoglycemia with coma, while the MS-DRG definitions manual places it among similar diabetes categories with and without coma. A separate reimbursement support resource also lists E13.641 for other specified diabetes mellitus with hypoglycemia with coma. 4 3 6

Clinical context

Hypoglycemia can be clinically classified according to its timing as fasting, postprandial, or exercise-related. Chronic hyperglycemia in diabetes mellitus can lead to disabling and life-threatening health complications, including microvascular and macrovascular complications. 2 1

Sources

1. Bookshelf — ncbi.nlm.nih.gov; accessed 2026-07-25.
2. Bookshelf — ncbi.nlm.nih.gov; accessed 2026-07-25.
3. ICD-10-CM/PCS MS-DRGv33 Definitions Manual — cms.gov; accessed 2026-07-25.
4. Article - Glucose Monitor - Policy Article (A52464) — cms.gov; accessed 2026-07-25.
5. 2026 ICD-10-CM E13.641: Other specified diabetes | HCC 36 — hccbuddy.com; accessed 2026-07-25.
6. INVOKAMET® XR ICD-10 Codes - Diabetes Mellitus — jnjwithme.com; accessed 2026-07-25.