E11.3513 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema…

ICD-10-CM · CMS code reference

E11.3513 codes type 2 diabetes with proliferative diabetic retinopathy plus macular edema (swelling of the macula), in both eyes. If only one eye is affected, use E11.3511 (right) or E11.3512 (left).

Official ICD-10-CM description: Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral

What to know

If the record says there is no macular edema, use E11.3593. A traction retinal detachment points to E11.3523, E11.3533 or E11.3543.

Coding notes

From the ICD-10-CM FY2027 (effective October 1, 2026) tabular list. Notes on a parent code or category apply here too.

Includes

diabetes (mellitus) due to insulin secretory defect
diabetes NOS
insulin resistant diabetes (mellitus)

Excludes1

Not coded together with this code. The exception is when the two conditions are unrelated to each other.

diabetes mellitus due to underlying condition (E08.-)
drug or chemical induced diabetes mellitus (E09.-)
gestational diabetes (O24.4-)
neonatal diabetes mellitus (P70.2)
postpancreatectomy diabetes mellitus (E13.-)
postprocedural diabetes mellitus (E13.-)
secondary diabetes mellitus NEC (E13.-)
type 1 diabetes mellitus (E10.-)

Use additional code

Add a second code for the following, when documented.

code to identify control using:
injectable non-insulin antidiabetic drugs (Z79.85)
insulin (Z79.4)
oral antidiabetic drugs (Z79.84)
oral hypoglycemic drugs (Z79.84)

Related codes

Common questions

Is E11.3513 a billable code?

Yes. E11.3513 is a billable ICD-10-CM code in the ICD-10-CM FY2027 (effective October 1, 2026) code set.