Skip to main content

E11.352 ICD-10-CM Code: Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula

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

Official Registry Overview & Definition

Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula is a non-billable ICD-10-CM category code (E11.352). A more specific billable subcode must be selected for claims submission.

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for E11.352 in the official ICD-10-CM tabular list.

Includes

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

  • diabetes (mellitus) due to insulin secretory defect
  • diabetes NOS
  • insulin resistant diabetes (mellitus)

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).

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)

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), type 2, with, retinopathy, proliferative, with, traction retinal detachment involving the macula
  • Diabetes, diabetic (mellitus) (sugar), with, retinopathy, proliferative, with, traction retinal detachment involving the macula

Frequently Compared Codes

The official Excludes notes on E11.352 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
    Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula
    FY2017 changes

Verify Before Coding

  • Not billable as written — a more specific code is required.
  • Requires a 7th character. "One of the following 7th characters is to be assigned to codes in subcategory E11.35 to designate laterality of the disease:" Options: E11.3521, E11.3522, E11.3523, E11.3529

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

Relationships & Classification

Other codes that name E11.352 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.

4 Excludes1 notes across 2 chapters: E08 (via E11.-), E09 (via E11.-), E10 (via E11.-), H36 (via E11.3.-).

Contextual Map

Every relationship of E11.352 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

  • E08 — Diabetes mellitus due to underlying condition [Excludes1](via E11.-): “type 2 diabetes mellitus (E11.-)” · check together
  • E09 — Drug or chemical induced diabetes mellitus [Excludes1](via E11.-): “type 2 diabetes mellitus (E11.-)” · check together
  • E10 — Type 1 diabetes mellitus [Excludes1](via E11.-): “type 2 diabetes mellitus (E11.-)” · check together
  • H36 — Retinal disorders in diseases classified elsewhere [Excludes1](via E11.3.-): “diabetic retinopathy (E08.3-, E09.3-, E10.3-, E11.3-, E13.3-)” · check together

Index entries

  • Diabetes, diabetic (mellitus) (sugar), type 2, with, retinopathy, proliferative, with, traction retinal detachment involving the macula[Index term]
  • Diabetes, diabetic (mellitus) (sugar), with, retinopathy, proliferative, with, traction retinal detachment involving the macula[Index term]

Nearest codes (40)

  • E11 — Type 2 diabetes mellitus [Sibling]
  • E11.3392 — Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye [Sibling]
  • E11.3393 — Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral [Sibling]
  • E11.3399 — Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye [Sibling]
  • E11.34 — Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy [Sibling]
  • E11.341 — Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema [Sibling]
  • E11.3411 — Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye [Sibling]
  • E11.3412 — Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye [Sibling]
  • and 32 more

Change history

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

Frequently Asked Questions (FAQ) & Clinical Guidance

Can E11.352 be billed directly?

No. E11.352 (Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Does E11.352 require a 7th character?

Yes. One of the following 7th characters is to be assigned to codes in subcategory E11.35 to designate laterality of the disease:.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to E11.352 in its code family, with their registry titles.

  • E11.351 — Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema
  • E11.3511 — Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
  • E11.3512 — Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
  • E11.3513 — Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
  • E11.3519 — Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
  • E11.3521 — Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
  • E11.3522 — Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
  • E11.3523 — Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
  • E11.3529 — Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
  • E11.353 — Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula

View all codes in the E11 family