Is E11.37X1 a billable ICD-10-CM code?

Yes. E11.37X1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does E11.37X1 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 E11.37X1?

E11.37X1 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 E11.37X1 (E11) and apply to it just the same.

E11.37X1

E11.37X1 — Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye

Billable / specific codeICD-10-CM

E11.37X1 is a billable, specific ICD-10-CM code for type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye. It is valid for submission on a claim.

7th character "1" — right eye

One of the following 7th characters is to be assigned to code E11.37 to designate laterality of the disease:

1: right eye
2: left eye
3: bilateral
9: unspecified eye

Excludes1 inherited from the categories above E11.37X1

These are not written on E11.37X1, but they bind it: a note on a category applies to every code beneath it. Billing E11.37X1 with anything listed here is a denial.

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 E11.37X1

These codes carry an Excludes1 note pointing at E11.37X1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading E11.37X1 alone.

E10Type 1 diabetes mellitus
E09Drug or chemical induced diabetes mellitus
E08Diabetes mellitus due to underlying condition

Risk adjustment

E11.37X1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 37 Diabetes with Chronic Complications0.166 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

E11.37X1 is named in 50 Medicare coverage policies — 49 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57069Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)not covered
A52464Glucose Monitor - Policy Article
A52501Therapeutic Shoes for Persons with Diabetes - Policy Article
A52507External Infusion Pumps - Policy Article

There’s a guided path to this code

Not sure E11.37X1 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.

Type 2 diabetes: chart note to code

The condition this code belongs to

Every code for the condition on one page, which one applies when, and the mistake coders make with it.

Type 2 diabetes ICD-10 codes

Code history

E11.37X1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share E11.37. If E11.37X1 is not quite right, the correct code is usually one of these.

Questions about E11.37X1

Is E11.37X1 a billable ICD-10-CM code?: Yes. E11.37X1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does E11.37X1 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 E11.37X1?: E11.37X1 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 E11.37X1 (E11) and apply to it just the same.