E13.37X1 — Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
E13.37X1 is a billable, specific ICD-10-CM code for other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right eye. It is valid for submission on a claim.
7th character "1" — right eye
One of the following 7th characters is to be assigned to code E13.37 to designate laterality of the disease:
- 1
- right eye
- 2
- left eye
- 3
- bilateral
- 9
- unspecified eye
Risk adjustment
E13.37X1 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
E13.37X1 is named in 45 Medicare coverage policies — 44 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57069Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)not covered
- A52464Glucose Monitor - Policy Article
- A52501Therapeutic Shoes for Persons with Diabetes - Policy Article
- A52507External Infusion Pumps - Policy Article
Related codes at this level
Codes that share E13.37. If E13.37X1 is not quite right, the correct code is usually one of these.
- E13.37X2Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
- E13.37X3Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
- E13.37X9Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
Questions about E13.37X1
- Is E13.37X1 a billable ICD-10-CM code?
- Yes. E13.37X1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does E13.37X1 sit in the tabular list?
- Endocrine, nutritional and metabolic diseases (E00-E89), in the block Diabetes mellitus (E08-E13).