Type 2 diabetes mellitus with proliferative diabetic retinopathy

Not billableICD-10-CM diagnosis code.

This code exists but cannot be submitted on its own. It groups the more specific codes beneath it.

A category header for its whole life, FY2016 onwards. It has never been valid for submission on its own.

Submit one of these 6 more specific codes instead:

E11.351 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema (also a header)
E11.352 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula (also a header)
E11.353 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula (also a header)
E11.354 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment (also a header)
E11.355 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy (also a header)
E11.359 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema (also a header)

What has happened to this code

Every change the publisher made, from 2012 to now. Entries marked draft are from the pre-implementation releases: ICD-10 took effect on 1 October 2015, so nothing before FY2016 was ever valid on a claim.

FY2012 Added to the draft code set draft Type 2 diabetes mellitus with proliferative diabetic retinopathy

Official coding rules

Published by CDC for FY2027. A rule attached to a category binds every code beneath it, so the rules inherited from this code's ancestors are shown with the code they come from.

Inherited from E11 Type 2 diabetes mellitus

Excludes1 - never coded here

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

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

Includes

diabetes (mellitus) due to insulin secretory defect
diabetes NOS
insulin resistant diabetes (mellitus)

Codes in the same group

Code	Description	Status
E11.31	Type 2 diabetes mellitus with unspecified diabetic retinopathy	Not billable
E11.32	Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy	Not billable
E11.33	Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy	Not billable
E11.34	Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy	Not billable
E11.36	Type 2 diabetes mellitus with diabetic cataract	Valid
E11.37	Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment	Not billable
E11.39	Type 2 diabetes mellitus with other diabetic ophthalmic complication	Valid