Index trail
Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
See Tabular List: E13.3549
E13, Other specified diabetes mellitus
E13.3, Other specified diabetes mellitus with ophthalmic complications
E13.35, Other specified diabetes mellitus with proliferative diabetic retinopathy
E13.354, Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
E13.3549, Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
Selected code, source checked for the selected effective period
Not listed for this effective period.
Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
Open the shareable code page for E13.3549→Not listed for this effective period.
No Excludes 1 note is listed in this source payload.
No Excludes 2 note is listed in this source payload.
Not listed for this effective period.
Not listed for this effective period.
Not listed for this effective period.
Not listed for this code in the selected Tabular payload.
Not listed for this code in the selected Tabular payload.
No laterality instruction is listed for this code in the selected Tabular payload.
Index trail
Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
See Tabular List: E13.3549
E13, Other specified diabetes mellitus
E13.3, Other specified diabetes mellitus with ophthalmic complications
E13.35, Other specified diabetes mellitus with proliferative diabetic retinopathy
E13.354, Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
E13.3549, Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
Selected code, source checked for the selected effective period
Not listed for this effective period.
Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
Open the shareable code page for E13.3549→Not listed for this effective period.
No Excludes 1 note is listed in this source payload.
No Excludes 2 note is listed in this source payload.
Not listed for this effective period.
Not listed for this effective period.
Not listed for this effective period.
Not listed for this code in the selected Tabular payload.
Not listed for this code in the selected Tabular payload.
No laterality instruction is listed for this code in the selected Tabular payload.
HCC Mapping
RAF Value
Model Period
Source
Audit Caution
HCC mapping, RAF, MEAT, source trail, and audit caution stay in view.
V28
HCC 37
Diabetes with Chronic Complications
RAF: 0.166
V24
HCC 18
Diabetes with Chronic Complications
RAF: 0.302
RxHCC
RxHCC 30
Diabetes with Complications
RAF: 0.495
ESRD/PACE
HCC 18
Diabetes with Chronic Complications
RAF: 0.084
HHS-HCC
HCC 20
HHS-HCC 20; HHS-HCC 2026 benefit year
RAF: Varies by metal level
MEAT checklist
Reviewed by the HCC Buddy Coding TeamMonitor, Evaluate, Assess, or Treat must be supported in the provider note.
HCC Buddy guidance, not official ICD-10-CM text.
Audit caution
Reviewed by the HCC Buddy Coding TeamClose codes need documentation support before selection. Do not assume relationships.
HCC Buddy guidance, not official ICD-10-CM text.
Reviewer sign-off
Reviewed by the HCC Buddy Coding TeamMEAT, documentation support, audit cautions, and close-code guidance are reviewed and approved for this effective period.
HCC Buddy enrichment is separate from official source text.
Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
CMS-HCC V28
HCC 37
RAF 0.166
CMS-HCC V24
HCC 18
RAF 0.302
RxHCC
RxHCC 30
RAF 0.495
Code
E13.3549
V28 HCC
HCC 37
RAF
0.166
Add close codes to compare documentation differences.
