E11.39 — Type 2 diabetes mellitus with other diabetic ophthalmic complication
E11.39 is a billable, specific ICD-10-CM code for type 2 diabetes mellitus with other diabetic ophthalmic complication. It is valid for submission on a claim.
Risk adjustment
E11.39 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
E11.39 is named in 42 Medicare coverage policies — 42 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52464Glucose Monitor - Policy Article
- A52501Therapeutic Shoes for Persons with Diabetes - Policy Article
- A52507External Infusion Pumps - Policy Article
- A52996Billing and Coding: Routine Foot Care
How E11.39 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to E11.39.
- Diabetes, diabetic›with›ophthalmic complication NEC
- Diabetes, diabetic›type 2›with›ophthalmic complication NEC
- Diabetes, diabetic›type 2›with›retinal, hemorrhage
There’s a guided path to this code
Not sure E11.39 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.
Related codes at this level
Codes that share E11.3. If E11.39 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
- E11.34Type 2 diabetes mellitus with severe 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
Questions about E11.39
- Is E11.39 a billable ICD-10-CM code?
- Yes. E11.39 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does E11.39 sit in the tabular list?
- Endocrine, nutritional and metabolic diseases (E00-E89), in the block Diabetes mellitus (E08-E13).