E11.34 — Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy
E11.34 is a non-billable header ICD-10-CM code for type 2 diabetes mellitus with severe nonproliferative 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 E11.34 to designate laterality of the disease:
- 1
- right eye
- 2
- left eye
- 3
- bilateral
- 9
- unspecified eye
Risk adjustment
E11.34 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.
There’s a guided path to this code
Not sure E11.34 is the right one? Answer a few questions about what the chart documents and we’ll walk you to the code that follows from it.
Code to one of these instead E11.34
2 child codes. Green means billable.
Related codes at this level
Codes that share E11.3. If E11.34 is not quite right, the correct code is usually one of these.
- E11.31Type 2 diabetes mellitus with unspecified diabetic retinopathy
- E11.32Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy
- E11.33Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy
- E11.35Type 2 diabetes mellitus with proliferative diabetic retinopathy
- E11.36Type 2 diabetes mellitus with diabetic cataract
- E11.37Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment
- E11.39Type 2 diabetes mellitus with other diabetic ophthalmic complication
Questions about E11.34
- Is E11.34 a billable ICD-10-CM code?
- No. E11.34 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does E11.34 sit in the tabular list?
- Endocrine, nutritional and metabolic diseases (E00-E89), in the block Diabetes mellitus (E08-E13).