ICD-10 Code E10.359 – Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code E10.359 – Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema
What it is
This code identifies type 1 diabetes complicated by proliferative diabetic retinopathy, with no macular edema documented. Use it when the retinal disease is due to diabetes and the macula is not involved.
Clinical signs
Findings may include neovascularization, retinal hemorrhage, or fibrous proliferation on eye examination. Clinical features vary; refer to documentation and ophthalmology reports for confirmation of proliferative disease and absence of macular edema.
When to use this code
Use this code when the record clearly links proliferative diabetic retinopathy to type 1 diabetes and states that macular edema is not present. It is appropriate for ophthalmology, endocrinology, or primary care documentation that confirms the ocular complication. Check documentation if the diabetes type or edema status is unclear.
Do not use for
Do not use this code for diabetic retinopathy without proliferative changes, or when macular edema is documented. Also avoid it if the chart does not specify type 1 diabetes. Check documentation.
Coding tip
Code the diabetes and eye complication exactly as documented, and verify laterality or edema details before assigning a more specific retinopathy code.