E10.3513
Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
HCC risk adjustment mapping
CMS-HCC V28
Diabetes with Chronic Complications
Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage
CMS-HCC ESRD V24
Diabetes with Chronic Complications
Proliferative Diabetic Retinopathy and Vitreous Hemorrhage
RxHCC V08
Diabetes with Complications
Coding notes
Excludes 1 never coded together · Excludes 2 may co-exist
One of the following 7th characters is to be assigned to codes in subcategory E10.35 to designate laterality of the disease:
| Character | Meaning |
|---|---|
| 1 | right eye |
| 2 | left eye |
| 3 | bilateral |
| 9 | unspecified eye |
brittle diabetes (mellitus) diabetes (mellitus) due to autoimmune process diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction idiopathic diabetes (mellitus) juvenile onset diabetes (mellitus) ketosis-prone diabetes (mellitus)
diabetes mellitus due to underlying condition (E08.-) drug or chemical induced diabetes mellitus (E09.-) gestational diabetes (O24.4-) hyperglycemia NOS (R73.9) neonatal diabetes mellitus (P70.2) postpancreatectomy diabetes mellitus (E13.-) postprocedural diabetes mellitus (E13.-) secondary diabetes mellitus NEC (E13.-) type 2 diabetes mellitus (E11.-)
transitory endocrine and metabolic disorders specific to newborn (P70-P74)
All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.
Official Guidelines for E10.3513
FY 2026 ›Subsections
Sections that reference E10.3513
- I.C.4.a.1)(a)Presymptomatic Type 1 Diabetes Mellitus
Codes E10.A-, Type 1 diabetes mellitus, presymptomatic, are assigned for early-stage type 1 diabetes that predates the onset of symptoms.
- I.C.4.aDiabetes mellitus
… Assign as many codes from categories E08 – E13 as needed to identify all of the associated conditions that the patient has.
- I.C.15.gDiabetes mellitus in pregnancyChapter 15
… O24, Diabetes mellitus in pregnancy, childbirth, and the puerperium, first, followed by the appropriate diabetes code(s) (E08-E13) from Chapter 4.
Sections whose FY 2026 text names E10.3513, its E10 category, or a range containing it — the chapter guidance above is the authoritative source.