E09.35 — Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy
E09.35 is a non-billable header ICD-10-CM code for drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
One of the following 7th characters is to be assigned to codes in subcategory E09.35 to designate laterality of the disease:
- 1
- right eye
- 2
- left eye
- 3
- bilateral
- 9
- unspecified eye
Excludes1 inherited from the categories above E09.35
These are not written on E09.35, but they bind it: a note on a category applies to every code beneath it. Billing E09.35 with anything listed here is a denial.
Written on E09 — Drug or chemical induced diabetes mellitus
- diabetes mellitus due to underlying condition (E08.-)
- 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.-)
Other codes that can never be billed with E09.35
These codes carry an Excludes1 note pointing at E09.35. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading E09.35 alone.
Risk adjustment
E09.35 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code history
E09.35 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Code to one of these instead E09.35
6 child codes. Green means billable.
- E09.351Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema
- E09.352Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula
- E09.353Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula
- E09.354Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
- E09.355Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy
- E09.359Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema
Related codes at this level
Codes that share E09.3. If E09.35 is not quite right, the correct code is usually one of these.
- E09.31Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy
- E09.32Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy
- E09.33Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy
- E09.34Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy
- E09.36Drug or chemical induced diabetes mellitus with diabetic cataract
- E09.37Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment
- E09.39Drug or chemical induced diabetes mellitus with other diabetic ophthalmic complication
Questions about E09.35
- Is E09.35 a billable ICD-10-CM code?
- No. E09.35 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does E09.35 sit in the tabular list?
- Endocrine, nutritional and metabolic diseases (E00-E89), in the block Diabetes mellitus (E08-E13).
- What cannot be coded together with E09.35?
- E09.35 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above E09.35 (E09) and apply to it just the same.