E13.3411
Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
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
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 E13.34 to designate laterality of the disease:
| Character | Meaning |
|---|---|
| 1 | right eye |
| 2 | left eye |
| 3 | bilateral |
| 9 | unspecified eye |
diabetes mellitus due to genetic defects of beta-cell function diabetes mellitus due to genetic defects in insulin action postpancreatectomy diabetes mellitus postprocedural diabetes mellitus secondary diabetes mellitus NEC
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.-)
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 E13.3411
FY 2026 ›Subsections
Sections that reference E13.3411
- I.C.4.a.6)Secondary diabetes mellitus
Codes under categories E08, Diabetes mellitus due to underlying condition, E09, Drug or chemical induced diabetes mellitus, and E13, Other specified diabetes mellitus, identify complications/manifestations associated with secondary diabetes mellitus. …
- I.C.4.a.6)(b)Assigning and sequencing secondary diabetes codes and its causes
… in relationship to codes for the cause of the diabetes is based on the Tabular List instructions for categories E08, E09 and E13.
- I.C.4.a.6)(b)(i)Secondary diabetes mellitus due to pancreatectomy
… Assign a code from category E13 as the principal or first- listed diagnosis and a code from subcategory Z90.41, Acquired absence of pancreas, as an additional …
- 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 E13.3411, its E13 category, or a range containing it — the chapter guidance above is the authoritative source.