E08.37X1 ICD-10-CM Code: Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right eye
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Inpatient Payment Groups (MS-DRG)
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0 (FY2026), Appendix B.
- MS-DRG 008 — SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT (MDC PRE)
- MS-DRG 010 — PANCREAS TRANSPLANT (MDC PRE)
- MS-DRG 019 — SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS (MDC PRE)
- MS-DRG 124 — OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT (MDC 02)
- MS-DRG 125 — OTHER DISORDERS OF THE EYE WITHOUT MCC (MDC 02)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Risk Adjustment (CMS-HCC)
Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.
- HCC 37 — Diabetes with Chronic Complications (supersedes HCC 38)
Other models: CMS-HCC V22 HCC 18 · RxHCC V08 HCC 30
Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.
Code Set: Valid FY2026 and FY2027. FY2026 took effect October 1, 2025.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for E08.37X1 in the official ICD-10-CM tabular list.
Excludes1 — Not Coded Here
Conditions that can never be reported with this code; the two are mutually exclusive.
- drug or chemical induced diabetes mellitus (E09.-)
- gestational diabetes (O24.4-)
- neonatal diabetes mellitus (P70.2)
- postpancreatectomy diabetes mellitus (E13.-)
- postprocedural diabetes mellitus (E13.-)
- secondary diabetes mellitus NEC (E13.-)
- type 1 diabetes mellitus (E10.-)
- type 2 diabetes mellitus (E11.-)
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 Asked Questions (FAQ) & Clinical Guidance
Does E08.37X1 require a 7th character?
Yes. One of the following 7th characters is to be assigned to code E08.37 to designate laterality of the disease:.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to E08.37X1 in its code family, with their registry titles.
- E08.3592 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eye
- E08.3593 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral
- E08.3599 — Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, unspecified eye
- E08.36 — Diabetes mellitus due to underlying condition with diabetic cataract
- E08.37 — Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment
- E08.37X2 — Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, left eye
- E08.37X3 — Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, bilateral
- E08.37X9 — Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, unspecified eye
- E08.39 — Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication
- E08.4 — Diabetes mellitus due to underlying condition with neurological complications