E08.311 vs H35.06

E08.311 (Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema) compared with H35.06 (Retinal vasculitis), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because H35.06 lists E08.311 under Excludes2, which marks them as distinct conditions.

Official rule

What is different?

The conditions named, billing status and chapter.E08.311 is “Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema”; H35.06 is “Retinal vasculitis”. H35.06 is a non-billable header; E08.311 is billable. E08.311 sits in E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89); H35.06 in H00-H59 — Diseases of the Eye and Adnexa (H00-H59).

Registry fact

Can these codes be reported together?

Yes, when both are documented.H35.06 lists E08.311 under Excludes2: “diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. E08.311 carries 8 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.H35.06’s tabular entry: “diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)”. The note covers E08.311.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.H35.06 is a non-billable header, but E08.311 is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

H35.06

Retinal vasculitis

↔

E08.311

Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema

What we found

Yes, when both are documented.H35.06 carries an Excludes2 note covering E08.311: “diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2 Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

Section I.A.12.b — Excludes2 · applies to: Excludes2
A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

	E08.311Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema	H35.06Retinal vasculitis
Billing status	Billable	Non-billable header Report instead: H35.061, H35.062, H35.063, H35.069
Classification	E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89)	H00-H59 — Diseases of the Eye and Adnexa (H00-H59)
Definition	Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema is a billable ICD-10-CM diagnosis code (E08.311).	Retinal vasculitis is a non-billable ICD-10-CM category code (H35.06).
Includes	—	Eales disease Retinal perivasculitis
Excludes1	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.-) type 2 diabetes mellitus (E11.-)	—
Excludes2	—	diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)
Code first	the underlying condition, such as: congenital rubella (P35.0)	—
Use additional code	code to identify control using: injectable non-insulin antidiabetic drugs (Z79.85) insulin (Z79.4)	—
Code also	—	any associated hypertension (I10)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources