ICD-10 Code E10.331 – Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code E10.331 – Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
What it is
This code identifies type 1 diabetes with moderate nonproliferative diabetic retinopathy and macular edema in one or both eyes. It signals diabetic eye damage with retinal changes and swelling involving the macula.
Clinical signs
Findings may include retinal microaneurysms, dot-blot hemorrhages, and other moderate nonproliferative changes. Macular edema may cause blurred or reduced central vision; clinical features vary, so refer to documentation.
When to use this code
Use E10.331 when the record clearly documents type 1 diabetes and moderate nonproliferative diabetic retinopathy with macular edema. Apply it when the eye condition is linked to diabetes and the severity is stated or supported by ophthalmology documentation.
If the note specifies laterality, follow the most specific available code options in the tabular list. Check documentation when the retinopathy grade or presence of macular edema is unclear.
Do not use for
Do not use this code for proliferative retinopathy, mild nonproliferative disease, or diabetic eye disease without macular edema. Do not assign it if the chart does not confirm type 1 diabetes.
Coding tip
Verify both the diabetes type and the exact retinopathy severity before coding; missing one element usually means you need a different code.