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Primary Code: E11.52 Diabetes with gangrene Additional Secondary Code: I96 Gangrene, not elsewhere classified Example Gangrene of right forefoot due to diabetes E11.52 + I96 Add ulcer codes if present Add PAD codes if documented (I73.x) When PAD or PVD is documented as related to diabetes: Primary Code: E11.51 Diabetes with peripheral angiopathy Secondary Code: I73.9 Peripheral vascular disease, unspecified (or a more specific I73.x code if documented) Example Type 2 diabetes with PAD E11.51 + I73.9 When diabetic retinopathy leads to visual impairment: Primary Code Appropriate E11.3x retinopathy code Secondary Code H54.x Level of visual impairment Example Severe NPDR in left eye with vision loss E11.339 + H54.62 These secondary codes do not replace the E11 codethey are added when medications are part of ongoing diabetes management