Coding and coverage · ICD-10-CM

E13 › E13.3 › E13.35

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

Not billable (header)Chapter 4

This code needs a 7th character (use X as a placeholder for missing characters).

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7th character codes

  • E13.3591 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
  • E13.3592 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
  • E13.3593 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
  • E13.3599 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye

Instructional notes

Chapter 4

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.
  • transitory endocrine and metabolic disorders specific to newborn (P70-P74)
Notes
  • 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.

E13

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.
  • 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.-)
Use additional codeAdd a second code for the full picture.
  • 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)
Includes
  • 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

E13.35

7th charactersOne 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

Chapter 4: Endocrine, nutritional and metabolic diseases · E08-E13 Diabetes mellitus (E08-E13)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.