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Compare/E10.3 vs H36

E10.3 vs H36

E10.3 (Type 1 diabetes mellitus with ophthalmic complications) compared with H36 (Retinal disorders in diseases classified elsewhere), 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. H36 carries an Excludes1 note covering E10.3: “diabetic retinopathy (E08.3-, E09.3-, E10.3-, E11.3-, E13.3-)”

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

E10.3Type 1 diabetes mellitus with ophthalmic complicationsH36Retinal disorders in diseases classified elsewhere
Billing statusNon-billable header

Report instead: E10.311, E10.319, E10.3211, E10.3212, E10.3213

Non-billable header

Report instead: H36.811, H36.812, H36.813, H36.819, H36.821

ClassificationE00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89)H00-H59 — Diseases of the Eye and Adnexa (H00-H59)
DefinitionType 1 diabetes mellitus with ophthalmic complications is a non-billable ICD-10-CM category code (E10.3).Retinal disorders in diseases classified elsewhere is a non-billable ICD-10-CM category code (H36).
Includes
brittle diabetes (mellitus)
diabetes (mellitus) due to autoimmune process
diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction
idiopathic diabetes (mellitus)
Code first
underlying disease, such as:
lipid storage disorders (E75.-)

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