ICD-10-CM code · FY2027
E11.359 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema
Header codeNot billable: use one of the 4 billable codes below
About E11.359
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Coding notes for E11.359
No notes of its own; the notes below apply from the codes above it.
7th character Required: add one of these as the 7th character, with X as a placeholder to fill six characters.
| Character | Meaning |
|---|---|
| 1 | right eye |
| 2 | left eye |
| 3 | bilateral |
| 9 | unspecified eye |
Also applies, from E11.35 Type 2 diabetes mellitus with proliferative diabetic retinopathy
7th character
- One of the following 7th characters is to be assigned to codes in subcategory E11.35 to designate laterality of the disease:
Also applies, from E11 Type 2 diabetes mellitus
Includes Conditions this code covers.
- diabetes (mellitus) due to insulin secretory defect
- diabetes NOS
- insulin resistant diabetes (mellitus)
Excludes1 Not coded here: never report these together with this code (use the code given instead).
- diabetes mellitus due to underlying condition (E08.-)
- drug or chemical induced diabetes mellitus (E09.-)
- gestational diabetes (O24.4-)
- neonatal diabetes mellitus (P70.2)
- postpancreatectomy diabetes mellitus (E13.-)
- postprocedural diabetes mellitus (E13.-)
- secondary diabetes mellitus NEC (E13.-)
- type 1 diabetes mellitus (E10.-)
Use additional code Add a second code for the detail named here.
Chapter 4 notes (apply to every code in it)
Note
- 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.
Codes under E11.359 4
- E11.3591 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eyeBillable
- E11.3592 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eyeBillable
- E11.3593 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateralBillable
- E11.3599 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eyeBillable
Related codes in E11.35
- E11.351 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edemaHeader
- E11.352 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the maculaHeader
- E11.353 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the maculaHeader
- E11.354 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachmentHeader
- E11.355 Type 2 diabetes mellitus with stable proliferative diabetic retinopathyHeader
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See 2MM+ plansICD-10-CM FY2027 code set, as published by the CDC National Center for Health Statistics (NCHS) and CMS, effective October 1, 2026 to September 30, 2027. Codes, titles and notes are shown as published. Check payer rules and the official guidelines before billing. This page is not medical advice.
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