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E10.3293 ICD-10-CM Code: Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

7th character
Required — see the character table on this page
Tabular directives
6 inclusion terms · 9 Excludes1
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 18 · RxHCC V08 category 30

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, 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.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for E10.3293 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on E10.3293 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • brittle diabetes (mellitus)
  • diabetes (mellitus) due to autoimmune process
  • diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction
  • idiopathic diabetes (mellitus)
  • juvenile onset diabetes (mellitus)
  • ketosis-prone diabetes (mellitus)

Source: inherited from E10

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).

Source: inherited from E10

7th Character Guide

"One of the following 7th characters is to be assigned to codes in subcategory E10.32 to designate laterality of the disease:"

  • 1 — right eye
  • 2 — left eye
  • 3 — bilateral (this page’s code)
  • 9 — unspecified eye

Variant codes in this family

E10.3291, E10.3292, E10.3293, E10.3299

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Coder workflow for E10.3293

MedCoder structured workflow — derived from this code’s own official record

Before you code E10.3293

  1. A 7th character is required in this family. Confirm the documentation supports the character assigned — its meaning in this family is defined in the official instruction. This page’s code carries “3”. The official 7th-character definitions for this family are quoted in the guide.

    See the 7th Character Guide

  2. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: bilateral). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    See the relationships section · Guide: Laterality coding →

  3. Confirm the documented diabetes type or cause (the E08–E13 categories are separated by it) and every documented complication or manifestation; the code is built from the type first and the complication second. Then work the category’s Use Additional Code notes for medication and control status. Type 2 is the default only when the type is not documented, and insulin or other medication use does not by itself establish the type (Guidelines I.C.4.a.2, I.C.4.a.3).

    Guide: Diabetes with multiple complications →

  4. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with E10.3293. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in E10.3293’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewE08, E09, O24.4, R73.9, P70.2, E13

  2. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.
  3. Does the documentation support one of this family’s 7th-character values?
    Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
    No → The code is invalid without its 7th character — query for the missing element.

Consider E10.3293. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).
7th-character basis
The documented element this family’s 7th character records (see the official definitions in the 7th Character Guide).
Severity
Mild, moderate or severe as the provider states it; severity is not inferred from the clinical picture.
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
Diabetes type or cause, each complication, and medication use
The type is documented, not inferred from medication (Guidelines I.C.4.a.3); each documented complication takes its own combination code.

Official instructions as workflow

  • Excludes1 — check before selecting E10.3293(9 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with E10.3293: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareE08, E09, O24.4, R73.9, P70.2, E13

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition E10.3293 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewE08, E09, O24.4, R73.9, P70.2, E13

Documentation: The record documents the condition on one side only.

Coding question: Which code in this family applies?

Path: Select the sibling code for the documented side.

Reason: Laterality is assigned from the documented side; the unspecified-side code is for records that state no side (Guidelines I.B.13).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral is a billable ICD-10-CM diagnosis code (E10.3293).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. A 7th character applies in this family. Confirm the documented encounter matches the character assigned. See the official 7th-character definitions and this code’s variants
  2. Laterality is coded in this family. Confirm the documented side matches the code — the opposite-side siblings are in the relationships section. See the opposite-side sibling codes
  3. 9 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name E10.3293 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 25 Excludes1 notes across 9 chapters: E08 — Diabetes mellitus due to underlying condition (via E10.-), E09 — Drug or chemical induced diabetes mellitus (via E10.-), E11 — Type 2 diabetes mellitus (via E10.-), E13 — Other specified diabetes mellitus (via E10.-), E74 — Other disorders of carbohydrate metabolism (via E10.-), E87.2 — Acidosis (via E10.-), G54.5 — Neuralgic amyotrophy (via E10.-), G59 — Mononeuropathy in diseases classified elsewhere (via E10.-), G63 — Polyneuropathy in diseases classified elsewhere (via E10.-), G99.0 — Autonomic neuropathy in diseases classified elsewhere (via E10.-), H20.0 — Acute and subacute iridocyclitis (via E10.-), H36 — Retinal disorders in diseases classified elsewhere (via E10.3.-), I73.8 — Other specified peripheral vascular diseases (via E10.-), I79.8 — Other disorders of arteries, arterioles and capillaries in diseases classified elsewhere (via E10.-), L92.1 — Necrobiosis lipoidica, not elsewhere classified (via E10.-), L99 — Other disorders of skin and subcutaneous tissue in diseases classified elsewhere (via E10.-), M14 — Arthropathies in other diseases classified elsewhere (via E10.-), M14.6 — Charcôt's joint (via E10.-), M90 — Osteopathies in diseases classified elsewhere (via E10.-), N08 — Glomerular disorders in diseases classified elsewhere (via E10.-), +5 more.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 2 Excludes2 notes across 2 chapters: H35 — Other retinal disorders (via E10.-), I96 — Gangrene, not elsewhere classified (via E10.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code First instruction: D84.81 — Immunodeficiency due to conditions classified elsewhere (via E10.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Referenced by 1 Code Also instruction: N76.82 — Fournier disease of vagina and vulva (via E10.-).

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 5 MS-DRGs: DRG 008 (MDC PRE), DRG 010 (MDC PRE), DRG 019 (MDC PRE), DRG 124 (MDC 02), DRG 125 (MDC 02).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):END003 — Diabetes mellitus with complication (default); END004 — Diabetes mellitus, Type 1; 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.

Related Codes

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Diabetes with Chronic Complications) for risk-adjusted payment.

E10.22 — Type 1 diabetes mellitus with diabetic chronic kidney disease, E10.29 — Type 1 diabetes mellitus with other diabetic kidney complication, E10.311 — Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema, E10.319 — Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema, E10.3211 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye, E10.3212 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye, E10.3213 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral, E10.3219 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye, E10.3291 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye, E10.3292 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye, E10.3299 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye, E10.3311 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye, E10.3312 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye, E10.3313 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral, E10.3319 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye, E10.3391 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye, E10.3392 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye, E10.3393 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral, E10.3399 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye, E10.3411 — Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye, +287 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Pancreas Transplant Status, Diabetes with Severe Acute Complications, Diabetes with Glycemic, Unspecified, or No Complications

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Diabetes mellitus with complication, Diabetes mellitus, Type 1, Retinal and vitreous conditions).

E10.311 — Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema, E10.319 — Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema, E10.321 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, E10.3211 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye, E10.3212 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye, E10.3213 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral, E10.3219 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye, E10.329 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, E10.3291 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye, E10.3292 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye, E10.3299 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye, E10.331 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, E10.3311 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye, E10.3312 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye, E10.3313 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral, E10.3319 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye, E10.339 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, E10.3391 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye, E10.3392 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye, E10.3393 — Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral, +910 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

HbA1c Test (Glycated Hemoglobin), Blood Glucose Test, Gamma-glutamyl Transferase (GGT) Test, Iron Panel, Lipid Panel, Thyroid Stimulating Hormone (TSH)

Contextual Map

Every relationship of E10.3293 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.

Run E10.3293 with these 12 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes (25)

Referenced by Excludes2 notes

  • H35 — Other retinal disorders[Excludes2](via E10.-): “diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • I96 — Gangrene, not elsewhere classified[Excludes2](via E10.-): “gangrene in diabetes mellitus (E08-E13 with .52)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code First instructions

Referenced by Code Also instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 37 — Diabetes with Chronic Complications [CMS-HCC]: “Diabetes with Chronic Complications — supersedes HCC 38 (Diabetes with Glycemic, Unspecified, or No Complications)”— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • Pre-MDC[MDC crossing]: “Pre-MDC — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 153 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
  • MDC 02 — Diseases and Disorders of the Eye[MDC crossing]: “Diseases and Disorders of the Eye — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,200 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Nearest codes (40)

Change history

Common coding questions

Does E10.3293 require a 7th character?

Yes. One of the following 7th characters is to be assigned to codes in subcategory E10.32 to designate laterality of the disease:.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "E10.3293 — Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/e10.3293-type-1-diabetes-mellitus-with-mild-nonproliferative-diabetic-retinopathy-without-macular-edema-bilateral

Change history

  • FY2017 — October 1, 2016
    Added to the code set
    Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
    FY2017 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to E10.3293 in its code family, with their registry titles.

View all codes in the E10 family