E13.351

Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema

Not billable — category only FY2026 2025-10-01 → 2026-09-30

Exclusions 8 never code together

E13code

Excludes1

diabetes (mellitus) due to autoimmune process (E10.-)E10.-
diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)E10.-
diabetes mellitus due to underlying condition (E08.-)E08.-
drug or chemical induced diabetes mellitus (E09.-)E09.-
gestational diabetes (O24.4-)O24.4-
neonatal diabetes mellitus (P70.2)P70.2
type 1 diabetes mellitus (E10.-)E10.-

E00-E89chapter

Excludes1

transitory endocrine and metabolic disorders specific to newborn (P70-P74)P70-P74

Excludes1 — never code together. The excluded condition and this one are mutually exclusive.

7th character 4

1 right eye this code

2 left eye

3 bilateral

9 unspecified eye

Instructional notes 11

E13code

Includes

diabetes mellitus due to genetic defects of beta-cell function
diabetes mellitus due to genetic defects in insulin action
postpancreatectomy diabetes mellitus
postprocedural diabetes mellitus
secondary diabetes mellitus NEC

Use additional code

code to identify control using:
injectable non-insulin antidiabetic drugs (Z79.85)Z79.85
insulin (Z79.4)Z79.4
oral antidiabetic drugs (Z79.84)Z79.84
oral hypoglycemic drugs (Z79.84)Z79.84

E00-E89chapter

Notes

All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.E05.8 E07.0 E16-E31 E34.-

Index entries leading here 2

Aneurysm (anastomotic) (artery) (cirsoid) (diffuse) (false) (fusiform) (multiple) (saccular) I72.9
- retina — see also Disorder, retina, microaneurysms
  - diabetic — see E08-E13 with .3-
Diabetes, diabetic (mellitus) (sugar) E11.9
- specified type NEC E13.9
  - with
    - retinopathy E13.319
      - proliferative E13.359
        
        with
        
        macular edema E13.351

Alongside this code 5 same parent — E13.35

E13.352 Oth diab with prolif diabetic rtnop with trctn dtch macula category E13.353 Oth diab with prolif diabetic rtnop with trctn dtch n-mcla category E13.354 Oth diabetes with prolif diabetic rtnop with combined detach category E13.355 Oth diabetes with stable proliferative diabetic retinopathy category E13.359 Oth diabetes w prolif diabetic retinopathy w/o macular edema category

Subordinate codes 4

E13.3511 Oth diab with prolif diab rtnop with macular edema, r eye E13.3512 Oth diab with prolif diab rtnop with macular edema, left eye E13.3513 Oth diab with prolif diabetic rtnop with macular edema, bi E13.3519 Oth diab with prolif diabetic rtnop with macular edema, unsp

Medications 5

232 Diabetes Mellitus drugs 20 Diabetic Retinopathy drugs 13 Macular Edema drugs 81 Diabetes Mellitus, Type 2 drugs 49 Diabetes Mellitus, Type 1 drugs

MED-RT files conditions by MeSH, which carves the world differently from ICD-10. These are name matches on this code's description, offered as candidates — not as an assertion that they are this code.

Additional references

AHA Coding Clinic® Licence required

Official coding advice for this code. Published by the American Hospital Association. Not included in this installation.

Risk adjustment

Maps to no condition category in any loaded model.

Presence is a property of the code. Untick a model to hide it everywhere.

This code

Billable: no
Code set: FY2026
Parent: E13.35
Block: E08-E13
Siblings: 5
Subordinate: 4

Present FY2024–FY2027.