ICD-10 Code E08.311 – Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code E08.311 – Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema
What it is
This code identifies diabetes caused by another underlying condition, with diabetic retinopathy affecting the eye and macular edema present. Use it when the record links the diabetes to the underlying condition and documents retinopathy without specifying the type.
Clinical signs
Clinical features may include retinal vascular changes, blurred vision, floaters, or decreased visual acuity. Macular edema is documented when swelling involves the macula; if details are limited, check documentation.
When to use this code
Use E08.311 when the provider documents diabetes due to an underlying condition and specifically notes unspecified diabetic retinopathy with macular edema. It is appropriate when the eye findings are tied to the diabetes and no more specific retinopathy type is stated.
Code it from ophthalmology, endocrinology, or primary care documentation if the relationship is clear. If the record names a different diabetic eye complication or does not confirm macular edema, do not assume this code.
Do not use for
Do not use this code for diabetes without an underlying-condition cause, or for retinopathy not linked to diabetes. Do not use it when the chart specifies a more detailed retinopathy code instead.
Coding tip
Verify both the underlying-condition diabetes and the exact eye complication wording before assigning E08.311.