FY2025
Effective from
- Inherited rules changed
Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema
Category — select a more specific code
CDC/NCHS · FY20251 — right eye
2 — left eye
3 — bilateral
9 — unspecified eye
For US diagnosis claims covered by HIPAA, ICD-10-CM is required from October 1, 2015.
Use the service date for outpatient/professional claims and the discharge date for hospital inpatient claims. Earlier encounters use ICD-9-CM; each individual code must also be valid for the applicable date.
Official coding guidelines → · CMS ↗First observed · 2015-10-01
Latest recorded change · FY2025
Effective from
Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema
Category — select a more specific code
CDC/NCHS · FY2025| All editions | Effective from | Code history |
|---|---|---|
| FY2016 | 2015-10-01 | First observed |
| FY2017 | 2016-10-01 | Specificity changed · Inherited rules changed |
| FY2018 | 2017-10-01 | Inherited rules changed |
| FY2019 | 2018-10-01 | No tabular change |
| FY2020 | 2019-10-01 | No tabular change |
| FY2020 · April | 2020-04-01 | No tabular change |
| FY2021 | 2020-10-01 | No tabular change |
| FY2021 · 01-01 | 2021-01-01 | No tabular change |
| FY2022 | 2021-10-01 | No tabular change |
| FY2022 · 04-01 | 2022-04-01 | No tabular change |
| FY2023 | 2022-10-01 | No tabular change |
| FY2023 · 04-01 | 2023-04-01 | No tabular change |
| FY2024 | 2023-10-01 | No tabular change |
| FY2024 · 04-01 | 2024-04-01 | No tabular change |
| FY2025 | 2024-10-01 | Inherited rules changed |
| FY2025 · 04-01 | 2025-04-01 | No tabular change |
| FY2026 | 2025-10-01 | No tabular change |
| FY2026 · April | 2026-04-01 | No tabular change |
| FY2027 | 2026-10-01 | No tabular change |
The official Tabular List has no additional instructions at this code level.
Review the instructions inherited from its parent categories below. Inherited instructions ↓
All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.
One of the following 7th characters is to be assigned to codes in subcategory E13.35 to designate laterality of the disease:
1 — right eye
2 — left eye
3 — bilateral
9 — unspecified eye
E13.3511Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eyeBillable / specificE13.3512Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eyeBillable / specificE13.3513Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateralBillable / specificE13.3519Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eyeBillable / specificOther entries in the same category; these are not automatic substitutes.
| Code | Description | Category · further specificity required |
|---|---|---|
| E13.352 | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula | Category · further specificity required |
| E13.353 | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula | Category · further specificity required |
| E13.354 | Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment | Category · further specificity required |
| E13.355 | Other specified diabetes mellitus with stable proliferative diabetic retinopathy | Category · further specificity required |
| E13.359 | Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema | Category · further specificity required |
Official titles and instructions are preserved in their source language. Official sources ↗