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E10.3493 vs E13

E10.3493 (Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral) compared with E13 (Other specified diabetes mellitus), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes should not be reported together because E10.3493’s tabular entry lists E13 under Excludes1.

Official rule
What is different?

The conditions named and billing status.E10.3493 is “Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral”; E13 is “Other specified diabetes mellitus”. E13 is a non-billable header; E10.3493 is billable.

Registry fact

Can these codes be reported together?

No.E10.3493’s entry carries an Excludes1 note covering E13: “postpancreatectomy diabetes mellitus (E13.-)”. Both may be reported only when the documentation shows the two conditions are unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

Yes.E10.3493’s tabular entry: “postpancreatectomy diabetes mellitus (E13.-)”. The note covers E13.

Official ruleGuide: Excludes1 vs Excludes2

Is one a parent or header code?

One is a header.E13 is a non-billable header, but E10.3493 is not one of its subdivisions.

Registry fact

Nothing found in 3 other checks; 1 check does not apply
Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code.

Official rule

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Excludes1 — generally not reported together

Excludes1 conflict

E10.3493
Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
↔
E13
Other specified diabetes mellitus

What we found

No — do not report together.E10.3493 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).

What to review

Report one of the two. Both may be reported only when the documentation shows the two conditions are unrelated to each other.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes1 note means the two conditions are not ordinarily reported together for the same encounter, because the classification treats them as mutually exclusive forms of the same condition. The documented exception is when the two conditions are unrelated to each other.

Source / rule

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

Official guidance behind these answers

  • Section I.A.12.a — Excludes1 · applies to: Excludes1

    A type 1 Excludes note is a pure excludes note. It means “NOT CODED HERE!” An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider. For example, code F45.8, Other somatoform disorders, has an Excludes1 note for "sleep related teeth grinding (G47.63)," because "teeth grinding" is an inclusion term under F45.8. Only one of these two codes should be assigned for teeth grinding. However psychogenic dysmenorrhea is also an inclusion term under F45.8, and a patient could have both this condition and sleep related teeth grinding. In this case, the two conditions are clearly unrelated to each other, and so it would be appropriate to report F45.8 and G47.63 together.

    ICD-10-CM Official Guidelines FY2027

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
E10.3493

Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral

E13

Other specified diabetes mellitus

StatusDiffers
E10.3493
Billable
E13
Non-billable header

A header is not reported on a claim; a code beneath it is.

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

Excludes1Differs
Only at E10.3493
  • hyperglycemia NOS (R73.9)
  • postpancreatectomy diabetes mellitus (E13.-)
  • postprocedural diabetes mellitus (E13.-)
  • secondary diabetes mellitus NEC (E13.-)
  • type 2 diabetes mellitus (E11.-)
Only at E13
  • diabetes (mellitus) due to autoimmune process (E10.-)
  • diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)
  • type 1 diabetes mellitus (E10.-)
Shared by both codes (4 notes)
  • diabetes mellitus due to underlying condition (E08.-)
  • drug or chemical induced diabetes mellitus (E09.-)
  • gestational diabetes (O24.4-)
  • neonatal diabetes mellitus (P70.2)
Use additional codeDiffers
E10.3493

None at this code

E13
  • code to identify control using:
  • injectable non-insulin antidiabetic drugs (Z79.85)
  • insulin (Z79.4)
  • oral antidiabetic drugs (Z79.84)
  • oral hypoglycemic drugs (Z79.84)
CategoryDiffers
E10.3493

E10 Type 1 diabetes mellitus

E13

Is itself a category

ChapterSame for both

E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89)

IncludesDiffers
E10.3493
  • brittle diabetes (mellitus)
  • diabetes (mellitus) due to autoimmune process
  • diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction
  • idiopathic diabetes (mellitus)
  • juvenile onset diabetes (mellitus)
  • ketosis-prone diabetes (mellitus)
E13
  • 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
  • secondary diabetes mellitus NEC
7th characterDiffers
E10.3493
  • One of the following 7th characters is to be assigned to codes in subcategory E10.34 to designate laterality of the disease:
E13

None at this code

No Excludes2, Code first and Code also note at either code.

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on. In a row that differs, each code’s own notes are listed under it, and the notes every code shares are listed once beneath them.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources