E10.3511 — Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
Is E10.3511 billable?
Yes — E10.3511 is billable for FY2027. E10.3511 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. E10.3511 may be submitted for encounters from October 1, 2026 through September 30, 2027.
E10.3511 at a glance
| Code | E10.3511 |
|---|---|
| Description | Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "1" | right eye |
What does the 7th character "1" mean in E10.3511?
In E10.3511, the 7th character 1 means right eye. The 7th character is required for E10.3511 to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does E10.3511 group to?
E10.3511 sits in MDC Pre and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 008Simultaneous Pancreas, Islet Cell and Kidney Transplantsurgical
How is E10.3511 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under E10.351, the nearest indexed parent of E10.3511. Use them to find the family, then select the specific code.
- Diabetes, diabetic › type 1 › with › retinopathy › proliferative › with › macular edema (mellitus) (sugar)
Excludes1 — never code together — inherited from Chapter 4
The conditions below can never be reported together with E10.3511 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- transitory endocrine and metabolic disorders specific to newborn (P70-P74)
Excludes1 — never code together — inherited from E10
The conditions below can never be reported together with E10.3511 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- diabetes mellitus due to underlying condition (E08.-)
- drug or chemical induced diabetes mellitus (E09.-)
- gestational diabetes (O24.4-)
- hyperglycemia NOS (R73.9)
- neonatal diabetes mellitus (P70.2)
- postpancreatectomy diabetes mellitus (E13.-)
- postprocedural diabetes mellitus (E13.-)
- secondary diabetes mellitus NEC (E13.-)
- type 2 diabetes mellitus (E11.-)
How long has E10.3511 existed?
E10.3511 first appears in FY2018 (FY2017 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.