ICDcodes.org
FY2027

E11.3543Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral

Billable

Is E11.3543 billable?

Yes — E11.3543 is billable for FY2027. E11.3543 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. E11.3543 may be submitted for encounters from October 1, 2026 through September 30, 2027.

E11.3543 at a glance

CodeE11.3543
DescriptionType 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027
7th character "3"bilateral

What does the 7th character "3" mean in E11.3543?

In E11.3543, the 7th character 3 means bilateral. The 7th character is required for E11.3543 to be a valid, complete code.

Same condition, different episode of care — switch the 7th character:

Which MS-DRGs does E11.3543 group to?

E11.3543 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 E11.3543 listed in the Alphabetic Index?

The Alphabetic Index lists these routes under E11.354, the nearest indexed parent of E11.3543. Use them to find the family, then select the specific code.

  • Diabetes, diabeticwithretinopathyproliferativewithcombined traction retinal detachment and rhegmatogenous retinal detachment (mellitus) (sugar)
  • Diabetes, diabetictype 2withretinopathyproliferativewithcombined traction retinal detachment and rhegmatogenous retinal detachment (mellitus) (sugar)

Excludes1 — never code together — inherited from Chapter 4

The conditions below can never be reported together with E11.3543 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 E11.3543 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 E11.3543 to fully describe the condition. E11.3543 is sequenced first.

  • 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)

How long has E11.3543 existed?

E11.3543 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.