E11.351 — Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema
Is E11.351 billable?
No — E11.351 is a non-billable header code. E11.351 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 4 billable codes beneath E11.351.
Billable codes under this header
- E11.3511Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
- E11.3512Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
- E11.3513Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
- E11.3519Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
E11.351 at a glance
| Code | E11.351 |
|---|---|
| Description | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
How is E11.351 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to E11.351. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Diabetes, diabetic › with › retinopathy › proliferative › with › macular edema (mellitus) (sugar)
- Diabetes, diabetic › type 2 › 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 E11.351 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 E11.351 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 E11.351 to fully describe the condition. E11.351 is sequenced first.
What codes fall under E11.351? (4)
- E11.3511Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
- E11.3512Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
- E11.3513Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
- E11.3519Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
How long has E11.351 existed?
E11.351 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
- FY2018: E11.351 stopped being billable
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
What other codes are in the E11.35 family? (5)
- E11.352Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the maculanot billable
- E11.353Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the maculanot billable
- E11.354Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachmentnot billable
- E11.355Type 2 diabetes mellitus with stable proliferative diabetic retinopathynot billable
- E11.359Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edemanot billable