E13.359

E13.359: Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema

Non-billable headerICD-10-CM

E13.359 is a non-billable header ICD-10-CM code for other specified diabetes mellitus with proliferative diabetic retinopathy without 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 E13.35 to designate laterality of the disease:

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

Excludes1 inherited from the categories above E13.359

A category’s note binds every code beneath it.

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 E13.359

Their own Excludes1 notes name this code, so the conflict is not listed above.

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

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Alphabetic index entries that lead here

Diabetes, diabetic›specified type NEC›with›retinopathy›proliferative

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead E13.359

4 child codes. Green means billable.