E13.37X1 ICD-10-CM Code: Other specified diabetes mellitus 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 E13.37X1 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 that can never be reported with this code; the two are mutually exclusive.
- diabetes (mellitus) due to autoimmune process (E10.-)
- diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)
- diabetes mellitus due to underlying condition (E08.-)
- drug or chemical induced diabetes mellitus (E09.-)
- gestational diabetes (O24.4-)
- neonatal diabetes mellitus (P70.2)
- type 1 diabetes mellitus (E10.-)
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 E13.37X1 require a 7th character?
Yes. One of the following 7th characters is to be assigned to code E13.37 to designate laterality of the disease:.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to E13.37X1 in its code family, with their registry titles.
- E13.3592 — Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
- E13.3593 — Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
- E13.3599 — Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye
- E13.36 — Other specified diabetes mellitus with diabetic cataract
- E13.37 — Other specified diabetes mellitus with diabetic macular edema, resolved following treatment
- E13.37X2 — Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
- E13.37X3 — Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
- E13.37X9 — Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
- E13.39 — Other specified diabetes mellitus with other diabetic ophthalmic complication
- E13.4 — Other specified diabetes mellitus with neurological complications