E11.34 ICD-10-CM Code: Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy
E11.34 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Diabetes mellitus (E08-E13)
E11.34
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceType 2 diabetes mellitus with severe nonproliferative diabetic retinopathy
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for E11.34. Check the code and parent instructions in the Code Book.
Excludes 2
OfficialNo Excludes 2 notes are included in this display for E11.34. Check the code and parent instructions in the Code Book.
Related Codes
Includes
Official- diabetes (mellitus) due to insulin secretory defectInherited from E11
- diabetes NOSInherited from E11
- insulin resistant diabetes (mellitus)Inherited from E11
Excludes 1
Official- transitory endocrine and metabolic disorders specific to newborn (P70-P74)Inherited from E00-E89, E11
- diabetes mellitus due to underlying condition (E08.-)Inherited from E00-E89, E11
- drug or chemical induced diabetes mellitus (E09.-)Inherited from E00-E89, E11
- gestational diabetes (O24.4-)Inherited from E00-E89, E11
- neonatal diabetes mellitus (P70.2)Inherited from E00-E89, E11
- postpancreatectomy diabetes mellitus (E13.-)Inherited from E00-E89, E11
- postprocedural diabetes mellitus (E13.-)Inherited from E00-E89, E11
- secondary diabetes mellitus NEC (E13.-)Inherited from E00-E89, E11
- type 1 diabetes mellitus (E10.-)Inherited from E00-E89, E11
Code First
OfficialNo Code First sequencing instructions are included in this display for E11.34. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify control using:Inherited from E11
- injectable non-insulin antidiabetic drugs (Z79.85)Inherited from E11
- insulin (Z79.4)Inherited from E11
- oral antidiabetic drugs (Z79.84)Inherited from E11
- oral hypoglycemic drugs (Z79.84)Inherited from E11
Code Also
OfficialNo Code Also instructions are included in this display for E11.34. Check the code and parent instructions in the Code Book.
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
- Code
- E11.34
- Description
- Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- No
- Payment year
- 2026
Coder workflow notes
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What This Code Means
E11.34 is the ICD-10-CM diagnosis code for type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy. E11.34 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering diabetes mellitus (e08-e13).
Header codes like E11.34 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for E11.34 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.