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E09.3523 vs E13

E09.3523 (Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral) 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.

Relationship

Conflict

Excludes1 conflict

E09.3523
Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
↔
E13
Other specified diabetes mellitus

Not coded here — these two are mutually exclusive.

“postpancreatectomy diabetes mellitus (E13.-)”

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Can these codes be reported together?

No — do not report together. E09.3523 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).

Side by side

E09.3523Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateralE13Other specified diabetes mellitus
Billing statusBillableNon-billable header

Report instead: E13.00, E13.01, E13.10, E13.11, E13.21

ClassificationE00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89)E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89)
DefinitionDrug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral is a billable ICD-10-CM diagnosis code (E09.3523).Other specified diabetes mellitus is a non-billable ICD-10-CM category code (E13).
7th characterOne of the following 7th characters is to be assigned to codes in subcategory E09.35 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 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 to identify control using:
injectable non-insulin antidiabetic drugs (Z79.85)
insulin (Z79.4)
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