E13.331 — Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
Is E13.331 billable?
No — E13.331 is a non-billable header code. E13.331 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 E13.331.
Billable codes under this header
- E13.3311Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
- E13.3312Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
- E13.3313Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
- E13.3319Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
E13.331 at a glance
| Code | E13.331 |
|---|---|
| Description | Other specified diabetes mellitus with moderate nonproliferative 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 E13.331 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to E13.331. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Diabetes, diabetic › specified type NEC › with › retinopathy › nonproliferative › moderate › with macular edema (mellitus) (sugar)
Excludes1 — never code together — inherited from Chapter 4
The conditions below can never be reported together with E13.331 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 E13
The conditions below can never be reported together with E13.331 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 autoimmune process (E10.-)
- diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)
- diabetes mellitus due to underlying condition (E08.-)
- drug or chemical induced diabetes mellitus (E09.-)
- gestational diabetes (O24.4-)
- neonatal diabetes mellitus (P70.2)
- type 1 diabetes mellitus (E10.-)
Use additional code — inherited from E13
Report an additional code alongside E13.331 to fully describe the condition. E13.331 is sequenced first.
What codes fall under E13.331? (4)
- E13.3311Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
- E13.3312Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
- E13.3313Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
- E13.3319Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
How long has E13.331 existed?
E13.331 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
- FY2018: E13.331 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.