E08.311Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema

E08.311 is the ICD-10-CM diagnosis code for diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema. It belongs to category E08 (diabetes mellitus due to underlying condition), block E08-E13 (diabetes mellitus) and chapter 4 (endocrine, nutritional and metabolic diseases). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within E08.31 (diabetes mellitus due to underlying condition with unspecified diabetic retinopathy), E08.311 is specifically for diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema. Related codes cover without macular edema (E08.319).

Code first the underlying condition, such as: congenital rubella (P35.0), Cushing's syndrome (E24.-), cystic fibrosis (E84.-), malignant neoplasm (C00-C96) and 2 more.

Use an additional code to identify control using: injectable non-insulin antidiabetic drugs (Z79.85), insulin (Z79.4), oral antidiabetic drugs (Z79.84) and oral hypoglycemic drugs (Z79.84).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 008 (Simultaneous Pancreas, Islet Cell and Kidney Transplant, relative weight 5.5146), DRG 010 (Pancreas or Islet Cell Transplant, relative weight 7.5259), DRG 019 (Simultaneous Pancreas, Islet Cell and Kidney Transplant with Hemodialysis, relative weight 7.5493), DRG 124 (Other Disorders of the Eye with MCC or Thrombolytic Agent, relative weight 1.2471) and DRG 125 (Other Disorders of the Eye without MCC, relative weight 0.7702), in Pre-MDC and MDC 02 (Diseases and Disorders of the Eye), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It is a manifestation code, so it describes the effect of an underlying disease and can't be the principal diagnosis. Code the underlying condition first.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as 249.50 (secondary diabetes mellitus with ophthalmic manifestations, not stated as uncontrolled, or unspecified), 249.50 (secondary diabetes mellitus with ophthalmic manifestations, not stated as uncontrolled, or unspecified), 362.01 (background diabetic retinopathy) and 1 more.