ICD-10 Code E11.311 – Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema (2026): Diagnosis, Symptoms & Billing Guide

The ICD-10 code for Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema is E11.311.
2026 ICD-10-CM Diagnosis Code E11.311 – Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema

What it is

This code identifies type 2 diabetes complicated by diabetic retinopathy when the retinopathy type is not further specified and macular edema is present. Use it when the record links both the diabetes and the eye complication.

Clinical signs

Clinical features vary; refer to documentation. Typical records mention diabetic retinal damage with macular swelling, often found on eye exam or retinal imaging, and may note blurred or reduced central vision.

When to use this code

Use this code when the provider documents type 2 diabetes and specifies unspecified diabetic retinopathy with macular edema in the same eye condition. It also fits when ophthalmology or primary care notes confirm diabetic retinal disease and macular edema but do not state the retinopathy subtype. If the documentation names another diabetes type or a different retinal disorder, do not use this code.

Do not use for

Do not use it for diabetes without retinal involvement, or for retinopathy that is not linked to type 2 diabetes. Check documentation if the chart names proliferative or nonproliferative retinopathy, because a more specific code may apply.

Coding tip

Verify that both “unspecified diabetic retinopathy” and “macular edema” are documented before assigning E11.311.

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *