New ICD-10-CM Code E11.A: Type 2 Diabetes Mellitus Without Complications in Remission

Background and FY 2026 Update

With the 2026 IPPS Proposed Final Rule comes a new diabetes code, E11.A, Type II diabetes mellitus without complications in remission. This is a non-CC/MCC and is assigned to MDC 10. 

ICD-10-CM Official Coding Guidance for E11.A

Section I.C.4.a.1.(b) - “Code E11.A, Type 2 diabetes mellitus without complications in remission, is assigned based on provider documentation that the diabetes mellitus is in remission. If the documentation is unclear as to whether the Type 2 diabetes mellitus has achieved remission, the provider should be queried. For example, the term “resolved” is not synonymous with remission.” 

Clinical Criteria for Diabetes Mellitus in Remission

Note* - Remission does not mean cure. Ongoing monitoring is essential as relapse is possible. 

1. Prior Diagnosis of Diabetes Mellitus 

• Documented history of type 2 diabetes mellitus, diagnosed using standard criteria: 
• HbA1c ≥ 6.5% 
• Fasting plasma glucose ≥ 126 mg/dL 
• 2-hour plasma glucose ≥ 200 mg/dL during an OGTT 
• Random plasma glucose ≥ 200 mg/dL with classic symptoms 

2. Normal or Controlled Glucose Levels Without Medications 

• The patient is not taking any antidiabetic medications (oral agents, insulin, or non-insulin injectables). 
• Glycemic control is sustained through lifestyle modifications, such as diet and exercise. 
• HbA1c < 6.5%, and sometimes < 6.0%, on two occasions at least 6 months apart without pharmacologic therapy. 

3. Duration of Remission 

• Partial remission: HbA1c < 6.5% and fasting glucose 100–125 mg/dL for at least 1 year without medications. 
• Complete remission: HbA1c in the normal range (<5.7%) and fasting glucose <100 mg/dL for at least 1 year. 
• Prolonged remission: Complete remission lasting ≥5 years. 

4. Documentation Must Include 

• Clear statement that diabetes is in remission or resolution. 
• No current use of diabetes medications. 
• Current HbA1c values. 
• Lifestyle interventions being used. 
• Absence of ongoing diabetic complications (or if present, they are noted as sequelae) 

5. What about Type I diabetes? Is remission associated? 

• “Honeymoon Phase” vs. Remission 
• Some individuals newly diagnosed with type 1 diabetes may experience a "honeymoon phase": 
• This is a temporary period (weeks to months) where insulin needs to decrease and blood glucose levels may normalize. 
• However, this is not true remission, as the autoimmune process continues and insulin dependence eventually returns. 

Clinical Scenario

Dr. Doctor, 

Documentation in your visit note indicates the patient has a documented history of type 2 diabetes mellitus, but current labs show: 

• HbA1c: 5.6% 
• No diabetes medications (e.g., insulin, metformin) currently prescribed 
• Patient reports lifestyle changes (e.g., diet and weight loss) 
• No hyperglycemia documented during this admission or recent visits 

Query 

Based on the clinical picture, can you please clarify the patient’s current diabetic status? 

☐ Type 2 diabetes mellitus – continue to document and treat as active 

☐ History of type 2 diabetes mellitus, currently in remission (no medications, normal glucose values) 

☐ Other: ________________