E13.3531 — Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
Is E13.3531 billable?
Yes, but E13.3531 is an unspecified code. E13.3531 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, E13.3531 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting E13.3531.
E13.3531 at a glance
| Code | E13.3531 |
|---|---|
| Description | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "1" | right eye |
What does the 7th character "1" mean in E13.3531?
In E13.3531, the 7th character 1 means right eye. The 7th character is required for E13.3531 to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does E13.3531 group to?
E13.3531 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 E13.3531 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under E13.353, the nearest indexed parent of E13.3531. Use them to find the family, then select the specific code.
- Diabetes, diabetic › specified type NEC › with › retinopathy › proliferative › with › traction retinal detachment not involving the macula (mellitus) (sugar)
Excludes1 — never code together — inherited from Chapter 4
The conditions below can never be reported together with E13.3531 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 E13.3531 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 E13.3531 to fully describe the condition. E13.3531 is sequenced first.
How long has E13.3531 existed?
E13.3531 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.