What is the minimum eGFR for SGLT2 inhibitors?

Minimum eGFR varies by agent: dapagliflozin (≥25), empagliflozin (≥20), canagliflozin (≥30), ertugliflozin (≥30), bexagliflozin (≥30), sotagliflozin (≥25). Always verify current FDA labeling.

What ICD-10 codes are used with SGLT2 inhibitors?

Common codes: E11.22 (T2D with diabetic CKD), N18.1–N18.6 (CKD stage), I50.20–I50.33 (heart failure by EF), Z79.84 (long-term oral hypoglycemic use).

SGLT2 Inhibitor Eligibility Calculator 2026|Latest eGFR Dosing & ICD-10 Coding

By Abeera Bhatti, Pharm-D & Saba Saeed, Pharm-D, M.Phil
Pharmaceutical Science Specialists | Clinical Pharmacy Experts

SGLT2 inhibitors now cover three overlapping indications — type 2 diabetes, heart failure (HFrEF and HFpEF), and chronic kidney disease — each with its own eGFR cutoff and outcomes evidence. Prescribing and coding both depend on knowing which drug is approved for which condition at which kidney function level.

This calculator runs your patient’s eGFR, diagnoses, and safety flags against each agent’s FDA label. It flags contraindications instantly and generates the ICD-10-CM codes typically paired with SGLT2 inhibitor therapy. Use it for clinical review and coding education — it does not replace the package insert, your pharmacist, or your facility’s coding guidelines.

Frequently Asked Questions About SGLT2 Inhibitors

What is the minimum eGFR to start SGLT2 inhibitors?

It depends on the drug. Empagliflozin has the lowest cutoff (eGFR ≥20), while dapagliflozin, ertugliflozin, canagliflozin, bexagliflozin, and sotagliflozin require eGFR ≥25–30. Always verify current FDA labeling before prescribing.

Which SGLT2 inhibitors are approved for heart failure?

Dapagliflozin, empagliflozin, and sotagliflozin all carry FDA approvals for heart failure in both reduced and preserved ejection fraction. Canagliflozin, ertugliflozin, and bexagliflozin do not have heart failure indications and should not be used as first-line agents for this condition.

Which SGLT2 inhibitors are approved for CKD?

Dapagliflozin and empagliflozin have earned FDA CKD outcomes indications. Canagliflozin is approved for type 2 diabetes with CKD and albuminuria. Sotagliflozin covers type 2 diabetes with CKD and established cardiovascular disease. Ertugliflozin and bexagliflozin do not have CKD indications.

Are SGLT2 inhibitors safe in pregnancy?

No. SGLT2 inhibitors are not recommended during pregnancy or when planning conception. Discontinue and switch to pregnancy-safe alternatives (such as insulin or methyldopa for hypertension) before conception or as soon as pregnancy is confirmed.

What are the key ICD-10 codes for SGLT2 inhibitor therapy?

Diabetes + CKD: E11.22 (type 2 DM with diabetic CKD) plus N18.1–N18.6 (CKD stage). Heart failure: I50.20–I50.33 (by EF status). Long-term therapy: Z79.84 (long-term oral hypoglycemic use). Always query providers for missing clinical specificity (e.g., heart failure EF status, CKD stage).

ICD-10-CM coding reference

Codes commonly documented alongside SGLT2 inhibitor therapy, based on the diagnoses selected above. This is an educational starting point, not a substitute for the ICD-10-CM Official Guidelines, payer LCD/NCD policy, or your facility’s CDI query process — always verify against the current code set and provider documentation.

Diabetes & kidney

Heart failure & therapy status

Sequencing & documentation tips

When CKD is documented as due to type 2 diabetes, ICD-10-CM requires the combination code (E11.22) plus a secondary code for the CKD stage (N18.–) — the two are reported together, not as alternatives.
Heart failure codes distinguish acute, chronic, and acute-on-chronic status, and separately whether ejection fraction is reduced, preserved, or unspecified. Query the provider if chart documentation doesn’t specify these.
Z79.84 (long-term use of oral hypoglycemic drugs) supports ongoing SGLT2 inhibitor therapy in the record and can matter for HCC/RAF capture — confirm it reflects current medications, not a discontinued regimen.
SGLT2 inhibitors prescribed purely for heart failure or CKD in a patient without diabetes should not default to a diabetes combination code — document and code the underlying condition on its own.
An initial creatinine rise after starting an SGLT2 inhibitor is an expected hemodynamic effect, not acute kidney injury — coding AKI here should follow explicit provider documentation, not the calculator or lab trend alone.

References

Primary sources used to build the eligibility logic above. Prescribing information changes — always confirm current labeling before clinical use.

01FDA prescribing information — Farxiga (dapagliflozin), AstraZeneca, current label, accessdata.fda.gov.

02FDA prescribing information — Jardiance (empagliflozin), Boehringer Ingelheim/Lilly, current label, accessdata.fda.gov.

03FDA prescribing information — Invokana (canagliflozin), Janssen, current label, accessdata.fda.gov.

04FDA prescribing information — Steglatro (ertugliflozin), Merck, current label, accessdata.fda.gov.

05FDA prescribing information — Brenzavvy (bexagliflozin), TheracosBio, current label, accessdata.fda.gov.

06FDA prescribing information — Inpefa (sotagliflozin), Lexicon Pharmaceuticals, current label, accessdata.fda.gov.

07American Diabetes Association. Standards of Care in Diabetes — 2026, Sections 9 (Cardiovascular Disease and Risk Management) and 11 (Chronic Kidney Disease and Risk Management). Diabetes Care.

08Kidney Disease: Improving Global Outcomes (KDIGO) 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.

09Heerspink HJL, et al. Dapagliflozin in Patients with Chronic Kidney Disease (DAPA-CKD). N Engl J Med. 2020.

10EMPA-KIDNEY Collaborative Group. Empagliflozin in Patients with Chronic Kidney Disease. N Engl J Med. 2023.