E11.3411 vs E13
E11.3411 (Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye) 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.
Can these codes be reported together?
No — do not report together. E11.3411 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).
No — do not report together. E11.3411 carries an Excludes1 note covering E13: “postprocedural 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).
No — do not report together. E11.3411 carries an Excludes1 note covering E13: “secondary diabetes mellitus NEC (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
| E11.3411Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye | E13Other specified diabetes mellitus | |
|---|---|---|
| Billing status | Billable | Non-billable header |
| Classification | E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89) | E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89) |
| Definition | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye is a billable ICD-10-CM diagnosis code (E11.3411). | Other specified diabetes mellitus is a non-billable ICD-10-CM category code (E13). |
| 7th character | One of the following 7th characters is to be assigned to codes in subcategory E11.34 to designate laterality of the disease: | — |
| Includes | diabetes (mellitus) due to insulin secretory defect diabetes NOS insulin resistant diabetes (mellitus) | 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 to identify control using: injectable non-insulin antidiabetic drugs (Z79.85) insulin (Z79.4) | 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