E08.321 ICD-10-CM Code: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for E08.321 in the official ICD-10-CM tabular list.
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- drug or chemical induced diabetes mellitus (E09.-) Compare E08.321 vs E09 →
- gestational diabetes (O24.4-) Compare E08.321 vs O24.4 →
- neonatal diabetes mellitus (P70.2) Compare E08.321 vs P70.2 →
- postpancreatectomy diabetes mellitus (E13.-) Compare E08.321 vs E13 →
- postprocedural diabetes mellitus (E13.-) Compare E08.321 vs E13 →
- secondary diabetes mellitus NEC (E13.-) Compare E08.321 vs E13 →
- type 1 diabetes mellitus (E10.-) Compare E08.321 vs E10 →
- type 2 diabetes mellitus (E11.-) Compare E08.321 vs E11 →
Code First
Underlying conditions that must be sequenced before this code.
Frequently Compared Codes
The official Excludes notes on E08.321 name these codes. Each comparison page covers when the two can — or must not — be reported together.
Change history
- FY2017 — 2016-10-01Became a non-billable headerfalseFY2017 changes
Verify Before Coding
- Not billable as written — a more specific code is required: E08.3211, E08.3212, E08.3213, E08.3219.
- Requires a 7th character. "One of the following 7th characters is to be assigned to codes in subcategory E08.32 to designate laterality of the disease:" Options: E08.3211, E08.3212, E08.3213, E08.3219
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.
Contextual Map
Every relationship of E08.321 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Hierarchy
- E00-E89 — Chapter 4: Endocrine, Nutritional and Metabolic Diseases (E00-E89) (E00-E89) [Hierarchy]
- E08-E13 — Diabetes mellitus [Hierarchy]
Referenced by Excludes1 notes (23)
- E09 — Drug or chemical induced diabetes mellitus [Excludes1](via E08.-): “diabetes mellitus due to underlying condition (E08.-)” · check together
- E10 — Type 1 diabetes mellitus [Excludes1](via E08.-): “diabetes mellitus due to underlying condition (E08.-)” · check together
- E11 — Type 2 diabetes mellitus [Excludes1](via E08.-): “diabetes mellitus due to underlying condition (E08.-)” · check together
- E13 — Other specified diabetes mellitus [Excludes1](via E08.-): “diabetes mellitus due to underlying condition (E08.-)” · check together
- E74 — Other disorders of carbohydrate metabolism [Excludes1](via E08.-): “diabetes mellitus (E08-E13)” · check together
- G54.5 — Neuralgic amyotrophy [Excludes1](via E08.-): “neuralgic amyotrophy in diabetes mellitus (E08-E13 with .44)” · check together
- G59 — Mononeuropathy in diseases classified elsewhere [Excludes1](via E08.-): “diabetic mononeuropathy (E08-E13 with .41)” · check together
- G63 — Polyneuropathy in diseases classified elsewhere [Excludes1](via E08.-): “diabetes mellitus (E08-E13 with .42)” · check together
- and 15 more
Referenced by Excludes2 notes
- I96 — Gangrene, not elsewhere classified [Excludes2](via E08.-): “gangrene in diabetes mellitus (E08-E13 with .52)” · check together
- R11.15 — Cyclical vomiting syndrome unrelated to migraine [Excludes2](via E08.-): “diabetes mellitus due to underlying condition (E08.-)” · check together
Referenced by Code First instructions
- D84.81 — Immunodeficiency due to conditions classified elsewhere [Code First](via E08.-): “diabetes mellitus (E08-E13)” · check together
Referenced by Code Also instructions
- N76.82 — Fournier disease of vagina and vulva [Code Also](via E08.-): “, if applicable, diabetes mellitus (E08-E13 with .9)” · check together
Clinical classification (CCSR)
- END003 — Diabetes mellitus with complication [CCSR]
- END006 — Diabetes mellitus, due to underlying condition, drug or chemical induced, or other specified type [CCSR]
- EYE005 — Retinal and vitreous conditions [CCSR]
Index entries
- Diabetes, diabetic (mellitus) (sugar), due to underlying condition, with, retinopathy, nonproliferative, mild, with macular edema[Index term]
- Diabetes, diabetic (mellitus) (sugar), due to underlying condition, with, retinopathy, nonproliferative, with macular edema[Index term]
Nearest codes (40)
- E08 — Diabetes mellitus due to underlying condition [Sibling]
- E08.0 — Diabetes mellitus due to underlying condition with hyperosmolarity [Sibling]
- E08.00 — Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) [Sibling]
- E08.01 — Diabetes mellitus due to underlying condition with hyperosmolarity with coma [Sibling]
- E08.1 — Diabetes mellitus due to underlying condition with ketoacidosis [Sibling]
- E08.10 — Diabetes mellitus due to underlying condition with ketoacidosis without coma [Sibling]
- E08.11 — Diabetes mellitus due to underlying condition with ketoacidosis with coma [Sibling]
- E08.2 — Diabetes mellitus due to underlying condition with kidney complications [Sibling]
- and 32 more
Change history
- FY2017 — Became a non-billable header [Change history]
Referenced by Other Codes
Clinical classification (AHRQ CCSR):END003 — Diabetes mellitus with complication (default); END006 — Diabetes mellitus, due to underlying condition, drug or chemical induced, or other specified type; EYE005 — Retinal and vitreous conditions.
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Official ICD-10-CM tabular notes on other codes that name E08.321 or its code family.
23 Excludes1 notes across 8 chapters: E09 (via E08.-), E10 (via E08.-), E11 (via E08.-), E13 (via E08.-), E74 (via E08.-), G54.5 (via E08.-), G59 (via E08.-), G63 (via E08.-), G99.0 (via E08.-), H20.0 (via E08.-) and 13 more.
2 Excludes2 notes across 2 chapters: I96 (via E08.-), R11.15 (via E08.-).
1 Code First instructions: D84.81 (via E08.-).
1 Code Also instructions: N76.82 (via E08.-).
Frequently Asked Questions (FAQ) & Clinical Guidance
Can E08.321 be billed directly?
No. E08.321 (Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Does E08.321 require a 7th character?
Yes. One of the following 7th characters is to be assigned to codes in subcategory E08.32 to designate laterality of the disease:.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to E08.321 in its code family, with their registry titles.
- E08.3 — Diabetes mellitus due to underlying condition with ophthalmic complications
- E08.31 — Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy
- E08.311 — Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema
- E08.319 — Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema
- E08.32 — Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy
- E08.3211 — Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye
- E08.3212 — Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye
- E08.3213 — Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral
- E08.3219 — Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
- E08.329 — Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema
Indexed Clinical Terms (2)
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.
- Diabetes, diabetic (mellitus) (sugar), due to underlying condition, with, retinopathy, nonproliferative, mild, with macular edema
- Diabetes, diabetic (mellitus) (sugar), due to underlying condition, with, retinopathy, nonproliferative, with macular edema