ICD-10 Code E11.319 – Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code E11.319 – Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema
What it is
This code identifies type 2 diabetes complicated by diabetic retinopathy, but the retinopathy type is not specified. It also confirms there is no macular edema documented.
Clinical signs
Clinical features vary; refer to documentation. Typical retinopathy findings may include retinal microvascular changes noted on eye exam, but you should not assume a specific severity level or laterality from this code.
When to use this code
Use this code when the record states type 2 diabetes with diabetic retinopathy and specifically says macular edema is absent. It also fits when the retinopathy is documented as diabetic but not further classified. If the chart does not clearly support the eye finding, check documentation.
Do not use for
Do not use this code if the record documents diabetic macular edema, a different diabetes type, or a more specific retinopathy category. Do not assign it when the eye diagnosis is not confirmed.
Coding tip
Verify both the diabetes type and the absence of macular edema before assigning E11.319.