E11.3413 — Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
Is E11.3413 billable?
Yes — E11.3413 is billable for FY2027. E11.3413 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. E11.3413 may be submitted for encounters from October 1, 2026 through September 30, 2027.
E11.3413 at a glance
| Code | E11.3413 |
|---|---|
| Description | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "3" | bilateral |
What does the 7th character "3" mean in E11.3413?
In E11.3413, the 7th character 3 means bilateral. The 7th character is required for E11.3413 to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does E11.3413 group to?
E11.3413 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 E11.3413 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under E11.341, the nearest indexed parent of E11.3413. Use them to find the family, then select the specific code.
- Diabetes, diabetic › with › retinopathy › nonproliferative › severe › with macular edema (mellitus) (sugar)
- Diabetes, diabetic › type 2 › with › retinopathy › nonproliferative › severe › with macular edema (mellitus) (sugar)
Excludes1 — never code together — inherited from Chapter 4
The conditions below can never be reported together with E11.3413 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 E11.3413 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 E11.3413 to fully describe the condition. E11.3413 is sequenced first.
How long has E11.3413 existed?
E11.3413 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.