E10.359 vs H35
E10.359 (Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema) compared with H35 (Other retinal disorders), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. H35 carries an Excludes2 note covering E10.359: “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
| E10.359Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema | H35Other retinal disorders | |
|---|---|---|
| Billing status | Non-billable header | Non-billable header |
| Classification | E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89) | H00-H59 — Diseases of the Eye and Adnexa (H00-H59) |
| Definition | Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema is a non-billable ICD-10-CM category code (E10.359). | Other retinal disorders is a non-billable ICD-10-CM category code (H35). |
| 7th character | One of the following 7th characters is to be assigned to codes in subcategory E10.35 to designate laterality of the disease: | — |
| Includes | brittle diabetes (mellitus) diabetes (mellitus) due to autoimmune process diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction idiopathic diabetes (mellitus) | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources