Diabetes remains one of the most commonly coded chronic conditions in healthcare. It is also one of the conditions that challenges new and experienced coders because of its wide range of complications and the need for accurate combination coding. With the 2026 ICD 10 CM updates we now have an important addition that helps us tell the patient story more accurately. A new code has been created for Type 2 diabetes in remission.

This update reflects something we are seeing more often in healthcare. Patients are making progress with lifestyle changes and many are improving after weight loss or bariatric surgery. Coding finally has a way to capture that improvement when it is clearly documented. The goal of this article is to walk you through the 2026 guidelines in a simple and practical way so you feel confident when you code diabetes in real patient scenarios.

⭐ A Closer Look at the New Code for 2026

The 2026 update introduces E11.A, which is used when a provider documents that a patient has Type 2 diabetes in remission without any active complications. This code allows coders to reflect patient improvement more accurately and supports better data reporting and monitoring.

You may assign E11.A when the provider clearly states that the diabetes is in remission and there are no diabetic complications documented anywhere in the record. If the patient has a history of bariatric surgery you may also assign Z98.84 for bariatric surgery status. These two codes together show both the present remission status and the past procedure that may have contributed to it.

⭐ When the Remission Code May Not Be Used

Although remission is documented the presence of an active diabetic complication means that E11.A cannot be assigned. Combination coding rules still apply and take priority.

Common diabetic complications include
chronic kidney disease
neuropathy
retinopathy
foot ulcers
peripheral angiopathy
ketoacidosis
hyperglycemia
hypoglycemia

If any of these conditions are linked to diabetes you must use the appropriate combination code.

Example

“Type 2 diabetes in remission with CKD stage 2”

Correct coding
E11.22 for Type 2 diabetes with diabetic CKD
N18.2 for CKD stage 2

Even though the provider used the term remission the complication continues to be present and related to diabetes. That is why the combination code is required.

⭐ When Remission Can Be Used with Other Conditions

There are situations where a patient may have another condition such as chronic kidney disease but that condition is not caused by diabetes. When the provider documents a different cause remission coding may be used.

Example

“Type 2 diabetes in remission. CKD stage 2 due to hypertension”

Correct coding
E11.A for Type 2 diabetes in remission
I12.9 for hypertensive CKD
N18.2 for CKD stage 2

The CKD in this example is not a diabetic complication. Because the documentation links it to hypertension remission coding is appropriate.

This is why reading provider documentation carefully is essential.

⭐ Now let's look look at some guidelines.

Scenario One

“Type 2 diabetes in remission. No complications. Prior bariatric surgery.”

Codes
E11.A
Z98.84

This is a straightforward remission situation with no active manifestations.

Scenario Two

“Type 2 diabetes in remission. CKD stage 2.”

Codes
E11.22
N18.2

Remission may not be used because a diabetic complication is still present.

Scenario Three

“Type 2 diabetes in remission. CKD stage 3 due to hypertension.”

Codes
E11.A
I12.9
N18.3

Remission applies because CKD is linked to hypertension and not diabetes.

⭐ Steps for Coding Diabetes

Here is a clear step by step approach that works in every diabetes case.

Step 1 Identify the diabetes category
E08
E09
E10
E11
E13

Step 2 Look for any diabetic complications
If complications are present you must assign the combination code

Step 3 Look for documentation of remission
Use E11.A only if remission is documented and no complications are linked to diabetes

Step 4 Assign additional codes as needed
CKD stage
Ulcer site
Wound type
Bariatric surgery status

Step 5 Add Z codes for treatment status when documented
Z79.4 for insulin use
Z79.84 for oral medications
Z79.85 for injectable non insulin medications

Step 6 Sequence correctly
Code the diabetes first when it is the underlying cause of the condition

This structure helps coders stay consistent and accurate while avoiding common errors.

⭐ Why Accurate Diabetes Coding Matters

Diabetes influences quality reporting risk adjustment and patient severity. Accurate coding ensures that complications are reported, that data reflects the true clinical picture, and that healthcare providers receive appropriate reimbursement for the complexity of care.

The addition of E11.A allows coders to report true remission but only when it is documented and when no diabetic related conditions remain. The key is careful reading and applying the guidelines with consistency.

⭐ Final Thoughts

Diabetes coding can seem intimidating at first glance but when you break it down into clear steps it becomes much easier. The 2026 update adds helpful clarity and gives coders a way to report patient improvement. Once you understand how remission fits into the larger framework of diabetes combination coding you will be able to approach every scenario with confidence.

If you want an easy reference that you can use at your desk you can download my Diabetes ICD 10 CM 2026 Cheat Sheet. It includes a remission decision guide combination code examples CKD pairing rules Z code reminders and real world scenarios to help you practice.

Making Coding Make Sense one code at a time.