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E11.352 vs O24.4

E11.352 (Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula) compared with O24.4 (Gestational diabetes mellitus), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Relationship

Conflict

Excludes1 conflict

E11.352
Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula
↔
O24.4
Gestational diabetes mellitus

Not coded here — these two are mutually exclusive.

“gestational diabetes (O24.4-)”

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

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

Can these codes be reported together?

No — do not report together. E11.352 carries an Excludes1 note covering O24.4: “gestational diabetes (O24.4-)”

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

E11.352Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the maculaO24.4Gestational diabetes mellitus
Billing statusNon-billable headerNon-billable header
ClassificationE00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89)O00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)
DefinitionType 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula is a non-billable ICD-10-CM category code (E11.352).Gestational diabetes mellitus is a non-billable ICD-10-CM category code (O24.4).
7th characterOne of the following 7th characters is to be assigned to codes in subcategory E11.35 to designate laterality of the disease:—
Includes
diabetes (mellitus) due to insulin secretory defect
diabetes NOS
insulin resistant diabetes (mellitus)
Diabetes mellitus arising in pregnancy
Gestational diabetes mellitus NOS
Use additional code
code to identify control using:
injectable non-insulin antidiabetic drugs (Z79.85)
insulin (Z79.4)
—
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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources