E13.3 ICD-10-CM Code: Other specified diabetes mellitus with ophthalmic complications
E13.3 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Diabetes mellitus (E08-E13)
E13.3
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceOther specified diabetes mellitus with ophthalmic complications
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 E13.3. Check the code and parent instructions in the Code Book.
Excludes 2
OfficialNo Excludes 2 notes are included in this display for E13.3. Check the code and parent instructions in the Code Book.
Related Codes
Includes
Official- diabetes mellitus due to genetic defects of beta-cell functionInherited from E13
- diabetes mellitus due to genetic defects in insulin actionInherited from E13
- postpancreatectomy diabetes mellitusInherited from E13
- postprocedural diabetes mellitusInherited from E13
- secondary diabetes mellitus NECInherited from E13
Excludes 1
Official- transitory endocrine and metabolic disorders specific to newborn (P70-P74)Inherited from E00-E89, E13
- diabetes (mellitus) due to autoimmune process (E10.-)Inherited from E00-E89, E13
- diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)Inherited from E00-E89, E13
- diabetes mellitus due to underlying condition (E08.-)Inherited from E00-E89, E13
- drug or chemical induced diabetes mellitus (E09.-)Inherited from E00-E89, E13
- gestational diabetes (O24.4-)Inherited from E00-E89, E13
- neonatal diabetes mellitus (P70.2)Inherited from E00-E89, E13
- type 1 diabetes mellitus (E10.-)Inherited from E00-E89, E13
Code First
OfficialNo Code First sequencing instructions are included in this display for E13.3. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify control using:Inherited from E13
- injectable non-insulin antidiabetic drugs (Z79.85)Inherited from E13
- insulin (Z79.4)Inherited from E13
- oral antidiabetic drugs (Z79.84)Inherited from E13
- oral hypoglycemic drugs (Z79.84)Inherited from E13
Code Also
OfficialNo Code Also instructions are included in this display for E13.3. 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
- E13.3
- Description
- Other specified diabetes mellitus with ophthalmic complications
- 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
E13.3 is the ICD-10-CM diagnosis code for other specified diabetes mellitus with ophthalmic complications. E13.3 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 E13.3 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 E13.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.