E13.331 — Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
E13.331 is a non-billable header ICD-10-CM code for other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema. 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 E13.33 to designate laterality of the disease:
- 1
- right eye
- 2
- left eye
- 3
- bilateral
- 9
- unspecified eye
Risk adjustment
E13.331 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.
How E13.331 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 E13.331.
- Diabetes, diabetic›specified type NEC›with›retinopathy›nonproliferative›moderate›with macular edema
Code to one of these instead E13.331
4 child codes. Green means billable.
- E13.3311Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
- E13.3312Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
- E13.3313Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
- E13.3319Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
Related codes at this level
Codes that share E13.33. If E13.331 is not quite right, the correct code is usually one of these.
Questions about E13.331
- Is E13.331 a billable ICD-10-CM code?
- No. E13.331 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does E13.331 sit in the tabular list?
- Endocrine, nutritional and metabolic diseases (E00-E89), in the block Diabetes mellitus (E08-E13).