E13.3
E13.3 — Other specified diabetes mellitus with ophthalmic complications
Non-billable headerICD-10-CM
E13.3 is a non-billable header ICD-10-CM code for other specified diabetes mellitus with ophthalmic complications. It cannot be billed on its own: choose one of the more specific child codes below.
Other codes that can never be billed with E13.3
These codes carry an Excludes1 note pointing at E13.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading E13.3 alone.
Risk adjustment
E13.3 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 to one of these instead E13.3
8 child codes. Green means billable.
- E13.31Other specified diabetes mellitus with unspecified diabetic retinopathy
- E13.32Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy
- E13.33Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy
- E13.34Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy
- E13.35Other specified diabetes mellitus with proliferative diabetic retinopathy
- E13.36Other specified diabetes mellitus with diabetic cataract
- E13.37Other specified diabetes mellitus with diabetic macular edema, resolved following treatment
- E13.39Other specified diabetes mellitus with other diabetic ophthalmic complication
Related codes at this level
Codes that share E13. If E13.3 is not quite right, the correct code is usually one of these.
- E13.0Other specified diabetes mellitus with hyperosmolarity
- E13.1Other specified diabetes mellitus with ketoacidosis
- E13.2Other specified diabetes mellitus with kidney complications
- E13.4Other specified diabetes mellitus with neurological complications
- E13.5Other specified diabetes mellitus with circulatory complications
- E13.6Other specified diabetes mellitus with other specified complications
- E13.8Other specified diabetes mellitus with unspecified complications
- E13.9Other specified diabetes mellitus without complications
Questions about E13.3
- Is E13.3 a billable ICD-10-CM code?
- No. E13.3 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does E13.3 sit in the tabular list?
- Endocrine, nutritional and metabolic diseases (E00-E89), in the block Diabetes mellitus (E08-E13).