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ICD-10-CM 2027 diagnosis code

E11.3552Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye

✓ Billable / specificRequires 7th character

E11.3552 is a valid, billable ICD-10-CM code for type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.Short description: Type 2 diabetes with stable prolif diabetic rtnop, left eye

Code last changed in FY2017 (effective October 1, 2016). Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data

About E11.3552

E11.3552 is the ICD-10-CM diagnosis code for type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye. It belongs to category E11 (type 2 diabetes mellitus), 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.

The 7th character "2" means left eye.

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 was added in FY2017, effective October 1, 2016.

Before ICD-10, this condition was coded in ICD-9-CM as 250.50 (diabetes with ophthalmic manifestations, type II or unspecified type, not stated as uncontrolled) and 362.02 (proliferative diabetic retinopathy).

7th character

2left eye

Other encounter types for E11.355:

Notes that apply from higher levels

Instructions written at a parent level also apply to E11.3552.

› From E11 Type 2 diabetes mellitus
Includes
  • diabetes (mellitus) due to insulin secretory defect
  • diabetes NOS
  • insulin resistant diabetes (mellitus)
Excludes1
  • diabetes mellitus due to underlying condition (E08.-)
  • drug or chemical induced diabetes mellitus (E09.-)
  • gestational diabetes (O24.4-)
  • neonatal diabetes mellitus (P70.2)
  • postpancreatectomy diabetes mellitus (E13.-)
  • postprocedural diabetes mellitus (E13.-)
  • secondary diabetes mellitus NEC (E13.-)
  • type 1 diabetes mellitus (E10.-)
Use additional code
  • code to identify control using:
  • injectable non-insulin antidiabetic drugs (Z79.85)
  • insulin (Z79.4)
  • oral antidiabetic drugs (Z79.84)
  • oral hypoglycemic drugs (Z79.84)

Broader instructions also apply from Chapter 4: Endocrine, nutritional and metabolic diseases.

MS-DRG v44.0 grouping

All DRGs →

Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.

ICD-9-CM equivalent

Converter →
  • 250.50Diabetes with ophthalmic manifestations, type II or unspecified type, not stated as uncontrolledapproximate, combination
  • 362.02Proliferative diabetic retinopathyapproximate, combination

From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2017 (effective 10/1/2016): Added
  • No changes since FY2017.

Common questions about E11.3552

Is E11.3552 billable?

Yes. E11.3552 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).

What does the "2" at the end of E11.3552 mean?

It is the 7th character for left eye.

Can E11.3552 be used as a principal diagnosis?

Yes. The Medicare Code Editor doesn't restrict E11.3552 as a principal diagnosis.

Is E11.3552 a CC or MCC?

No. E11.3552 is neither a CC nor an MCC under MS-DRG v44.0.

What DRG does E11.3552 group to?

E11.3552 is used in the MS-DRG v44.0 logic for MS-DRG 008 (Simultaneous Pancreas, Islet Cell and Kidney Transplant), MS-DRG 010 (Pancreas or Islet Cell Transplant), MS-DRG 019 (Simultaneous Pancreas, Islet Cell and Kidney Transplant with Hemodialysis), MS-DRG 124 (Other Disorders of the Eye with MCC or Thrombolytic Agent) and MS-DRG 125 (Other Disorders of the Eye without MCC). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.

What is the ICD-9 code for E11.3552?

The CMS General Equivalence Mappings map E11.3552 to ICD-9-CM 250.50 and 362.02.