ICD-10 Code E11.341 – Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code E11.341 – Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema
What it is
This code identifies type 2 diabetes with severe nonproliferative diabetic retinopathy and macular edema in one or both eyes. It reflects advanced retinal damage from diabetes plus swelling in the macula.
Clinical signs
Findings may include retinal hemorrhages, venous changes, intraretinal microvascular abnormalities, and macular thickening or swelling on eye examination. Clinical features vary; refer to documentation.
When to use this code
Use this code when the provider documents type 2 diabetes and specifically states severe nonproliferative diabetic retinopathy with macular edema. Apply it for either eye or both eyes when the record supports this combination.
If the note only says diabetic retinopathy, or does not confirm macular edema, check documentation before assigning E11.341. Code the documented eye condition exactly as recorded.
Do not use for
Do not use this code for proliferative retinopathy, mild or moderate nonproliferative retinopathy, or diabetic eye disease without macular edema. Check documentation if the severity is unclear.
Coding tip
Verify that both the retinopathy severity and macular edema are documented before you assign E11.341.