E08.3542 vs E11
E08.3542 (Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye) compared with E11 (Type 2 diabetes mellitus), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. E08.3542 carries an Excludes1 note covering E11: “type 2 diabetes mellitus (E11.-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. E11 carries an Excludes1 note covering E08.3542: “diabetes mellitus due to underlying condition (E08.-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| E08.3542Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye | E11Type 2 diabetes mellitus | |
|---|---|---|
| Billing status | Billable | Non-billable header |
| Classification | E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89) | E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89) |
| Definition | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye is a billable ICD-10-CM diagnosis code (E08.3542). | Type 2 diabetes mellitus is a non-billable ICD-10-CM category code (E11). |
| 7th character | One of the following 7th characters is to be assigned to codes in subcategory E08.35 to designate laterality of the disease: | — |
| Includes | — | diabetes (mellitus) due to insulin secretory defect diabetes NOS insulin resistant diabetes (mellitus) |
| Use additional code | code to identify control using: injectable non-insulin antidiabetic drugs (Z79.85) insulin (Z79.4) | code to identify control using: injectable non-insulin antidiabetic drugs (Z79.85) insulin (Z79.4) |
| Code first | the underlying condition, such as: congenital rubella (P35.0) | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources