E11.39

Billable

Type 2 diabetes mellitus with other diabetic ophthalmic complication

HCC Category Mapping

V28HCC 37 — Diabetes with Chronic Complications

0.245

V24HCC 18 — Diabetes with Chronic Complications

0.302

ESRDHCC 18 — Diabetes with Chronic Complications

0.000

RxHCCHCC 30 — Diabetes with Complications

0.000

What This Code Means

Type 2 diabetes with eye complications other than retinopathy or cataracts, such as diabetic macular edema, glaucoma, or other vision problems caused by diabetes.

Coding Tips

•Use this code only when the eye complication is not retinopathy or cataract
•Document the specific ophthalmic complication in the medical record for clarity and future reference

Clinical Significance

Type 2 diabetes mellitus with other diabetic ophthalmic complication captures eye conditions attributable to diabetes beyond retinopathy and cataract, such as diabetic papillopathy, cranial nerve palsies affecting extraocular muscles, neovascular glaucoma, or diabetic maculopathy without retinopathy classification. These less common ophthalmic complications still represent significant visual morbidity requiring specialized care.

Documentation Requirements

✓The medical record must identify the specific ophthalmic complication and its relationship to Type 2 diabetes.
✓Comprehensive eye examination findings, specialized testing (visual fields, tonometry, OCT), and treatment plans should be documented.
✓The provider must confirm the condition is not retinopathy or cataract, which have their own specific codes.

Use Additional Code

code to identify manifestation, such as:
diabetic glaucoma (H40-H42)

Commonly Confused Codes

E11.311/E11.319 (diabetic retinopathy with/without macular edema) are specific to retinal vascular disease.E11.36 (diabetic cataract) covers lens opacity.H40 series (glaucoma) codes may be used additionally when neovascular glaucoma is documented.E11.69 (other specified complication) is too broad when the complication is specifically ophthalmic.

Code Hierarchy

└E11Type 2 diabetes mellitus └E11.3Type 2 diabetes mellitus with ophthalmic complications └E11.39Type 2 diabetes mellitus with other diabetic ophthalmic complication

└E11.39Type 2 diabetes mellitus with other diabetic ophthalmic complication