ICD-10 Code E13.321 – Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code E13.321 – Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema
What it is
This code identifies diabetes from another specified cause, not type 1 or type 2, with mild nonproliferative diabetic retinopathy and macular edema. It reflects documented eye involvement related to the diabetes.
Clinical signs
Findings may include retinal microaneurysms, dot-blot hemorrhages, or mild retinal changes, plus macular swelling on eye examination. Clinical features vary; refer to documentation.
When to use this code
Use this code when the record clearly states other specified diabetes mellitus and the ophthalmology note documents mild nonproliferative retinopathy with macular edema. You should link the eye complication to the diabetes in the chart. If the diabetes type is not specified, check documentation before assigning this code.
Do not use for
Do not use it for type 1 or type 2 diabetes, or when retinopathy is absent. Do not assign it if macular edema or retinopathy severity is not documented.
Coding tip
Confirm both the diabetes category and the exact eye complication wording before coding.