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E13.3411 vs P70.2

E13.3411 (Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye) compared with P70.2 (Neonatal 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

E13.3411
Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
↔
P70.2
Neonatal diabetes mellitus

Not coded here — these two are mutually exclusive.

“neonatal diabetes mellitus (P70.2)”

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. E13.3411 carries an Excludes1 note covering P70.2: “neonatal diabetes mellitus (P70.2)”

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

E13.3411Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eyeP70.2Neonatal diabetes mellitus
Billing statusBillableBillable
ClassificationE00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89)P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96)
DefinitionOther specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye is a billable ICD-10-CM diagnosis code (E13.3411).Neonatal diabetes mellitus is a billable ICD-10-CM diagnosis code (P70.2).
7th characterOne of the following 7th characters is to be assigned to codes in subcategory E13.34 to designate laterality of the disease:—
Includes
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
transitory endocrine and metabolic disturbances caused by the infant's response to maternal endocrine and metabolic factors, or its adjustment to extrauterine environment
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