ICD-10 Code E10.311 – Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code E10.311 – Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema
What it is
This code identifies type 1 diabetes with diabetic retinopathy that is not further specified, plus macular edema. Use it when the record confirms both the retinal disease and swelling involving the macula.
Clinical signs
Clinical features may include blurred or distorted vision, reduced central vision, or retinal findings consistent with diabetic eye disease. Clinical features vary; refer to documentation.
When to use this code
Use E10.311 when the provider documents type 1 diabetes and diabetic retinopathy, but does not specify the retinopathy type beyond “unspecified,” and macular edema is also documented. It applies to confirmed diabetic eye involvement, not mere screening or suspicion. Check documentation if laterality or retinopathy severity is stated elsewhere.
Do not use for
Do not use this code if the chart documents diabetic retinopathy without macular edema, or if the diabetes type is not type 1. Also avoid it when another more specific retinopathy code is documented.
Coding tip
Code the diabetes complication exactly as documented, and verify that both retinopathy and macular edema are present before assigning E10.311.