E11.3599 vs E13
E11.3599 (Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified 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. E11.3599 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. E11.3599 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. E11.3599 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
| E11.3599Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified 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 proliferative diabetic retinopathy without macular edema, unspecified eye is a billable ICD-10-CM diagnosis code (E11.3599). | 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 E11.35 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