ICD-10 Code E13.331 – Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code E13.331 – Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
What it is
This code identifies diabetes mellitus due to another specified cause, along with moderate nonproliferative diabetic retinopathy and macular edema. Use it when the record links these eye findings to the diabetes type documented as “other specified.”
Clinical signs
Typical findings include retinal microaneurysms, hemorrhages, and hard exudates consistent with moderate nonproliferative retinopathy. Macular edema may be documented by ophthalmology; clinical features vary, so refer to documentation.
When to use this code
Use this code when the provider documents other specified diabetes mellitus and clearly states moderate nonproliferative diabetic retinopathy with macular edema. It also fits when the eye condition is recorded as diabetic and the diabetes type is not type 1, type 2, or gestational. Check documentation for laterality and any additional eye findings.
Do not use for
Do not use it if the chart does not confirm diabetic retinopathy with macular edema, or if the diabetes type is unspecified. Do not use for non-diabetic retinal disease or proliferative retinopathy.
Coding tip
Verify that the diabetes type is documented as “other specified” before assigning E13.331.