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E11.352 ICD-10-CM Code: Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula

E11.352 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupE11.352

FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Diabetes mellitus (E08-E13)

E11.352

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula

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

Inclusion Terms

Official

No inclusion terms are included in this display for E11.352. Check the code and parent instructions in the Code Book.

Excludes 2

Official

No Excludes 2 notes are included in this display for E11.352. Check the code and parent instructions in the Code Book.

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

Official

No Code First sequencing instructions are included in this display for E11.352. 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

Official

No Code Also instructions are included in this display for E11.352. 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
E11.352
Description
Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula
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

E11.352 is the ICD-10-CM diagnosis code for type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula. E11.352 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 E11.352 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 E11.352 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

E11.352 code history

Code setChange
FY2017 (effective Oct 1, 2016)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Also searched as

  • E11 352
  • E11352

More on E11.352

Code family

Every E11 code with its CMS-HCC V28 statusType 2 diabetes mellitus, 87 billable codes

Related condition guides

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