ICDcodes.org
FY2027

E11.359 — Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema

Not billable

Is E11.359 billable?

No — E11.359 is a non-billable header code. E11.359 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 E11.359.

E11.359 at a glance

CodeE11.359
DescriptionType 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema
BillableNo — header code
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

How is E11.359 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to E11.359. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Diabetes, diabetic › with › retinopathy › proliferative (mellitus) (sugar)
  • Diabetes, diabetic › type 2 › with › retinopathy › proliferative (mellitus) (sugar)

Excludes1 — never code together — inherited from Chapter 4

The conditions below can never be reported together with E11.359 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 E11.359 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 E11.359 to fully describe the condition. E11.359 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)

What codes fall under E11.359? (4)

How long has E11.359 existed?

E11.359 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

  • FY2018: E11.359 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.

Which conditions are coded to E11.359?

What other codes are in the E11.35 family? (5)