E11.311 vs H35
E11.311 (Type 2 diabetes mellitus with unspecified diabetic retinopathy with 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 E11.311: “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
| E11.311Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema | H35Other retinal disorders | |
|---|---|---|
| Billing status | Billable | 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 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema is a billable ICD-10-CM diagnosis code (E11.311). | Other retinal disorders is a non-billable ICD-10-CM category code (H35). |
| Includes | diabetes (mellitus) due to insulin secretory defect diabetes NOS insulin resistant diabetes (mellitus) | — |
| Use additional code | code to identify control using: injectable non-insulin antidiabetic drugs (Z79.85) insulin (Z79.4) | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources