ICD-10 Code E13.311 – Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code E13.311 – Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema
What it is
This code identifies diabetes mellitus of another specified type, along with diabetic retinopathy and macular edema in the same eye or both eyes when the retinopathy type is not further specified.
Clinical signs
Clinical features may include retinal vascular changes and swelling in the macula causing blurred or distorted vision. Clinical features vary; refer to documentation.
When to use this code
Use this code when the provider documents other specified diabetes mellitus and also documents unspecified diabetic retinopathy with macular edema. It applies when the retinopathy is diabetic and the macular edema is present, but the retinopathy subtype is not named. Check documentation if laterality or retinopathy detail is unclear.
Do not use for
Do not use this code if the record does not confirm diabetic retinopathy with macular edema. Do not assign it when the diabetes type is not “other specified” or when the eye findings are non-diabetic.
Coding tip
Verify both the diabetes category and the eye complication in the provider note before assigning E13.311.