E11.354: Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
E11.354 is a non-billable header ICD-10-CM code for type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment. 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 E11.35 to designate laterality of the disease:
- 1
- right eye
- 2
- left eye
- 3
- bilateral
- 9
- unspecified eye
Excludes1 inherited from the categories above E11.354
A category’s note binds every code beneath it.
Written on E11: Type 2 diabetes mellitus
- diabetes mellitus due to underlying condition (E08.-)
- drug or chemical induced diabetes mellitus (E09.-)
- 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.-)
Other codes that can never be billed with E11.354
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Alphabetic index entries that lead here
- Diabetes, diabetic›with›retinopathy›proliferative›with›combined traction retinal detachment and rhegmatogenous retinal detachment
- Diabetes, diabetic›type 2›with›retinopathy›proliferative›with›combined traction retinal detachment and rhegmatogenous retinal detachment
There’s a guided path to this code
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.
Code to one of these instead E11.354
4 child codes. Green means billable.
- E11.3541Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
- E11.3542Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
- E11.3543Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
- E11.3549Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
Other codes under E11.35
- E11.351Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema
- E11.352Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula
- E11.353Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula
- E11.355Type 2 diabetes mellitus with stable proliferative diabetic retinopathy
- E11.359Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema