E09.311 vs H35.3213

E09.311 (Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema) compared with H35.3213 (Exudative age-related macular degeneration, right eye, with inactive scar), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Relationship

Informational

Excludes2 relationship

H35.3213

Exudative age-related macular degeneration, right eye, with inactive scar

↔

E09.311

Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema

Distinct conditions — both may be reported.

“diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)”

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: CMS ICD-10-CM tabular instructional notes

Can these codes be reported together?

Yes, when both are documented. H35.3213 carries an Excludes2 note covering E09.311: “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.

Side by side

	E09.311Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema	H35.3213Exudative age-related macular degeneration, right eye, with inactive scar
Billing status	Billable	Billable
Classification	E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89)	H00-H59 — Diseases of the Eye and Adnexa (H00-H59)
Definition	Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema is a billable ICD-10-CM diagnosis code (E09.311).	Exudative age-related macular degeneration, right eye, with inactive scar is a billable ICD-10-CM diagnosis code (H35.3213).
7th character	—	One of the following 7th characters is to be assigned to codes in subcategory H35.32 to designate the stage of the disease:
Use additional code	code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5) code to identify control using: injectable non-insulin antidiabetic drugs (Z79.85)	—
Code first	poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4)	—

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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources