ICD-10 Code E11.321 – Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code E11.321 – Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema
What it is
This code identifies type 2 diabetes with mild nonproliferative diabetic retinopathy and macular edema in the same eye or both eyes. It signals diabetic eye disease that has progressed beyond simple retinopathy.
Clinical signs
Findings may include retinal microaneurysms, dot-blot hemorrhages, or hard exudates, along with macular swelling documented on eye exam. Clinical features vary; refer to documentation.
When to use this code
Use this code when the provider documents type 2 diabetes and specifically links mild nonproliferative diabetic retinopathy with macular edema to the patient. It may appear in ophthalmology, primary care, or diabetes follow-up notes. If laterality or severity is unclear, check documentation before coding.
Do not use for
Do not use it for diabetes without retinopathy, retinopathy without macular edema, or more advanced diabetic eye disease. Do not assume the code if the record does not clearly connect the eye findings to diabetes.
Coding tip
Verify that both retinopathy severity and macular edema are documented, and confirm the diabetes type before assigning E11.321.