E11.311 — Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema
Is E11.311 billable?
Yes, but E11.311 is an unspecified code. E11.311 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, E11.311 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting E11.311 — the more specific alternatives are listed below.
More specific alternatives
E11.311 at a glance
| Code | E11.311 |
|---|---|
| Description | Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does E11.311 group to?
E11.311 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 E11.311 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to E11.311. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Diabetes, diabetic › with › retinopathy › with macular edema (mellitus) (sugar)
- Diabetes, diabetic › type 2 › with › retinopathy › with macular edema (mellitus) (sugar)
Excludes1 — never code together — inherited from Chapter 4
The conditions below can never be reported together with E11.311 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 E11
The conditions below can never be reported together with E11.311 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-)
- 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 — inherited from E11
Report an additional code alongside E11.311 to fully describe the condition. E11.311 is sequenced first.
How long has E11.311 existed?
E11.311 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.