ICD-10 Code E13.319 – Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code E13.319 – Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema
What it is
This code identifies diabetes mellitus that is not type 1 or type 2, along with diabetic retinopathy affecting the eyes. The retinopathy is documented, but macular edema is not present or not specified.
Clinical signs
Clinical features may include retinal microvascular changes such as hemorrhages, exudates, or neovascularization. Vision may be blurred or unchanged; clinical features vary, so refer to documentation.
When to use this code
Use E13.319 when the record clearly states other specified diabetes mellitus and diabetic retinopathy, but does not identify the retinopathy type beyond unspecified. Apply it when macular edema is absent or specifically ruled out. If the chart names a more specific retinopathy type, code that instead.
Do not use for
Do not use this code if the record documents macular edema, because a different code is required. Do not use it when the diabetes type is type 1 or type 2, or when retinopathy is not documented.
Coding tip
Check the ophthalmology note for both the diabetes category and whether macular edema is present before assigning E13.319.