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E13.352 ICD-10-CM Code: Other specified 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

Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula is a non-billable ICD-10-CM category code (E13.352). A more specific billable subcode must be selected for claims submission.

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for E13.352 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 genetic defects of beta-cell function
  • diabetes mellitus due to genetic defects in insulin action
  • postpancreatectomy diabetes mellitus
  • postprocedural diabetes mellitus
  • secondary diabetes mellitus NEC

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)

Frequently Compared Codes

The official Excludes notes on E13.352 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
    Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula
    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 E13.352 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 E13.-): “postpancreatectomy diabetes mellitus (E13.-)” · check together
  • E09 — Drug or chemical induced diabetes mellitus [Excludes1](via E13.-): “postpancreatectomy diabetes mellitus (E13.-)” · check together
  • E10 — Type 1 diabetes mellitus [Excludes1](via E13.-): “postpancreatectomy diabetes mellitus (E13.-)” · check together
  • E11 — Type 2 diabetes mellitus [Excludes1](via E13.-): “postpancreatectomy diabetes mellitus (E13.-)” · check together
  • H36 — Retinal disorders in diseases classified elsewhere [Excludes1](via E13.3.-): “diabetic retinopathy (E08.3-, E09.3-, E10.3-, E11.3-, E13.3-)” · check together

Referenced by Code First instructions

  • E89.1 — Postprocedural hypoinsulinemia [Code First](via E13.-): “, if applicable, diabetes mellitus (postpancreatectomy) (postprocedural) (E13.-)” · check together

Referenced by Use Additional Code instructions

  • Z90.41 — Acquired absence of pancreas [Use Additional Code](via E13.-): “diabetes mellitus, postpancreatectomy (E13.-)” · check together

Index entries

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

Nearest codes (40)

  • E13 — Other specified diabetes mellitus [Sibling]
  • E13.3392 — Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye [Sibling]
  • E13.3393 — Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral [Sibling]
  • E13.3399 — Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye [Sibling]
  • E13.34 — Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy [Sibling]
  • E13.341 — Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema [Sibling]
  • E13.3411 — Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye [Sibling]
  • E13.3412 — Other specified 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]

Referenced by Other Codes

Official ICD-10-CM tabular notes on other codes that name E13.352 or its code family.

5 Excludes1 notes across 2 chapters: E08 (via E13.-), E09 (via E13.-), E10 (via E13.-), E11 (via E13.-), H36 (via E13.3.-).

1 Code First instructions: E89.1 (via E13.-).

1 Use Additional Code instructions: Z90.41 (via E13.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Can E13.352 be billed directly?

No. E13.352 (Other specified 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 E13.352 require a 7th character?

Yes. One of the following 7th characters is to be assigned to codes in subcategory E13.35 to designate laterality of the disease:.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to E13.352 in its code family, with their registry titles.

  • E13.351 — Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema
  • E13.3511 — Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
  • E13.3512 — Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
  • E13.3513 — Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
  • E13.3519 — Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
  • E13.3521 — Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
  • E13.3522 — Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
  • E13.3523 — Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
  • E13.3529 — Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
  • E13.353 — Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula

View all codes in the E13 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), specified type NEC, with, retinopathy, proliferative, with, traction retinal detachment involving the macula