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E08.355 ICD-10-CM Code: Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Official Registry Overview & Definition

Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy is a non-billable ICD-10-CM category code (E08.355). A more specific billable subcode must be selected for claims submission.

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for E08.355 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).

Code First

Underlying conditions that must be sequenced before this code.

  • the underlying condition, such as:
  • congenital rubella (P35.0)
  • Cushing's syndrome (E24.-)
  • cystic fibrosis (E84.-)
  • malignant neoplasm (C00-C96)
  • malnutrition (E40-E46)
  • pancreatitis and other diseases of the pancreas (K85-K86.-)

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to identify control using:
  • injectable non-insulin antidiabetic drugs (Z79.85)
  • insulin (Z79.4)
  • oral antidiabetic drugs (Z79.84)
  • oral hypoglycemic drugs (Z79.84)

Frequently Compared Codes

The official Excludes notes on E08.355 name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy
    FY2017 changes

Verify Before Coding

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 E08.355 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

Index entries

  • Diabetes, diabetic (mellitus) (sugar), due to underlying condition, with, retinopathy, proliferative, with, stable proliferative diabetic retinopathy[Index term]

Nearest codes (40)

  • E08 — Diabetes mellitus due to underlying condition [Sibling]
  • E08.351 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema [Sibling]
  • E08.3511 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye [Sibling]
  • E08.3512 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eye [Sibling]
  • E08.3513 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral [Sibling]
  • E08.3519 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, unspecified eye [Sibling]
  • E08.352 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula [Sibling]
  • E08.3521 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye [Sibling]
  • and 32 more

Change history

  • FY2017 — Added to the code set [Change history]

Referenced by Other Codes

Official ICD-10-CM tabular notes on other codes that name E08.355 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 E08.355 be billed directly?

No. E08.355 (Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Does E08.355 require a 7th character?

Yes. One of the following 7th characters is to be assigned to codes in subcategory E08.35 to designate laterality of the disease:.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to E08.355 in its code family, with their registry titles.

  • E08.354 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
  • E08.3541 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
  • E08.3542 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
  • E08.3543 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
  • E08.3549 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
  • E08.3551 — Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye
  • E08.3552 — Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eye
  • E08.3553 — Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral
  • E08.3559 — Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, unspecified eye
  • E08.359 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema

View all codes in the E08 family

Indexed Clinical Terms (1)

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, proliferative, with, stable proliferative diabetic retinopathy