E08.3542 vs E13
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 E13 (Other specified 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 E13: “postpancreatectomy diabetes mellitus (E13.-)”
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. E08.3542 carries an Excludes1 note covering E13: “postprocedural diabetes mellitus (E13.-)”
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. E08.3542 carries an Excludes1 note covering E13: “secondary diabetes mellitus NEC (E13.-)”
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. E13 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 | E13Other specified 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). | Other specified diabetes mellitus is a non-billable ICD-10-CM category code (E13). |
| 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 genetic defects of beta-cell function diabetes mellitus due to genetic defects in insulin action postpancreatectomy diabetes mellitus postprocedural 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