FY2027 ICD-10-CM reference
E13.359: Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema
By the HCC Buddy Coding Team
The official ICD-10-CM descriptor is Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Nonbillable heading. Verified against the official FY2027 order file.
More specific FY2027 codes
- E13.3591: Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eyeBillable code
- E13.3592: Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eyeBillable code
- E13.3593: Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateralBillable code
- E13.3599: Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eyeBillable code
FY2027 Tabular instructions
Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.
Instructional note
All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.
Source: E00-E89 (chapter, inherited).
Excludes1
transitory endocrine and metabolic disorders specific to newborn (P70-P74)
Source: E00-E89 (chapter, inherited).
Includes
diabetes mellitus due to genetic defects of beta-cell function
Source: E13 (category, inherited).
Includes
diabetes mellitus due to genetic defects in insulin action
Source: E13 (category, inherited).
Includes
postpancreatectomy diabetes mellitus
Source: E13 (category, inherited).
Includes
postprocedural diabetes mellitus
Source: E13 (category, inherited).
Includes
secondary diabetes mellitus NEC
Source: E13 (category, inherited).
Instructional note
code to identify control using:
Source: E13 (category, inherited).
Instructional note
injectable non-insulin antidiabetic drugs (Z79.85)
Source: E13 (category, inherited).
Instructional note
insulin (Z79.4)
Source: E13 (category, inherited).
Instructional note
oral antidiabetic drugs (Z79.84)
Source: E13 (category, inherited).
Instructional note
oral hypoglycemic drugs (Z79.84)
Source: E13 (category, inherited).
Excludes1
diabetes (mellitus) due to autoimmune process (E10.-)
Source: E13 (category, inherited).
Excludes1
diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)
Source: E13 (category, inherited).
Excludes1
diabetes mellitus due to underlying condition (E08.-)
Source: E13 (category, inherited).
Excludes1
drug or chemical induced diabetes mellitus (E09.-)
Source: E13 (category, inherited).
Excludes1
gestational diabetes (O24.4-)
Source: E13 (category, inherited).
Excludes1
neonatal diabetes mellitus (P70.2)
Source: E13 (category, inherited).
Excludes1
type 1 diabetes mellitus (E10.-)
Source: E13 (category, inherited).
Seventh-character instruction
One of the following 7th characters is to be assigned to codes in subcategory E13.35 to designate laterality of the disease:
Source: E13.35 (self, inherited).
Instructional note
right eye
Source: E13.35 (self, inherited).
Instructional note
left eye
Source: E13.35 (self, inherited).
Instructional note
bilateral
Source: E13.35 (self, inherited).
Instructional note
unspecified eye
Source: E13.35 (self, inherited).
Seventh-character definitions
- 1: right eye
- 2: left eye
- 3: bilateral
- 9: unspecified eye
Compare the FY2027 additions, removals and billable-status changes
What does E13.359 mean in FY2027?
The official ICD-10-CM descriptor is Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Is E13.359 billable in FY2027?
The FY2027 order file marks E13.359 as a nonbillable heading. Select a complete billable child code.
Does E13.359 map to an HCC?
Risk-model mapping is not applicable to this nonbillable heading. Check a complete billable child code.
Source: CMS FY2027 ICD-10-CM order file. Payment model: CMS CY 2027 Rate Announcement. Read the FY2027 Official Guidelines.
Review the FY2026 April edition