Is E13.354 a billable ICD-10-CM code?

No. E13.354 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does E13.354 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 E13.354?

E13.354 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 E13.354 (E13) and apply to it just the same.

E13.354

E13.354 — Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment

Non-billable headerICD-10-CM

E13.354 is a non-billable header ICD-10-CM code for other specified 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 E13.35 to designate laterality of the disease:

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

Excludes1 inherited from the categories above E13.354

These are not written on E13.354, but they bind it: a note on a category applies to every code beneath it. Billing E13.354 with anything listed here is a denial.

Written on E13 — Other specified diabetes mellitus

diabetes (mellitus) due to autoimmune process (E10.-)
diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)
diabetes mellitus due to underlying condition (E08.-)
drug or chemical induced diabetes mellitus (E09.-)
gestational diabetes (O24.4-)
neonatal diabetes mellitus (P70.2)
type 1 diabetes mellitus (E10.-)

Other codes that can never be billed with E13.354

These codes carry an Excludes1 note pointing at E13.354. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading E13.354 alone.

E10Type 1 diabetes mellitus
E11Type 2 diabetes mellitus
E09Drug or chemical induced diabetes mellitus
E08Diabetes mellitus due to underlying condition

Risk adjustment

E13.354 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 E13.354 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 E13.354.

Diabetes, diabetic›specified type NEC›with›retinopathy›proliferative›with›combined traction retinal detachment and rhegmatogenous retinal detachment

Code history

E13.354 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead E13.354

4 child codes. Green means billable.

Related codes at this level

Codes that share E13.35. If E13.354 is not quite right, the correct code is usually one of these.

Questions about E13.354

Is E13.354 a billable ICD-10-CM code?: No. E13.354 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does E13.354 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 E13.354?: E13.354 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 E13.354 (E13) and apply to it just the same.