2026 ICD-10-CM Diagnosis Code E08.311Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema

ICD-10-CM Codes›E00–E89›E08-E13›E08

ICD-10-CM E08.311
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

E08.311 is a billable ICD-10-CM diagnosis code for diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 124 through 125. The code is a manifestation code that cannot be reported as the principal diagnosis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Diabetes mellitus with complication; Diabetes mellitus, due to underlying condition, drug or chemical induced, or other specified type; and Retinal and vitreous conditions.

Code Identity

ICD-10-CM Code
E08.311
Billable Status
Yes — Valid for Submission
Code Describes
Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema
Short Description
Diab due to undrl cond w unsp diabetic rtnop w macular edema
Parent Code
E08.31
Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy

Code Classification

ChapterE00–E89Endocrine, nutritional and metabolic diseases
SectionE08-E13Diabetes mellitus
CategoryE08Diabetes mellitus due to underlying condition
This CodeE08.311Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema

Code EditsBilling

Medicare Code Editor checks that affect claim validity for E08.311.

Manifestation diagnoses
Manifestation codes describe the manifestation of an underlying disease, not the disease itself, and therefore should not be used as a principal diagnosis.

Coding GuidelinesGuidance

The diabetes mellitus codes are combination codes that include the type of diabetes mellitus, the body system affected, and the complications affecting that body system. As many codes within a particular category as are necessary to describe all of the complications of the disease may be used. They should be sequenced based on the reason for a particular encounter. Assign as many codes from categories E08 - E13 as needed to identify all of the associated conditions that the patient has.

Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Diabetes, diabetic(mellitus) (sugar)
      • due to underlying condition
        • with
          • retinopathy
            • with macular edema

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR END003
Diabetes mellitus with complication
Default principal diagnosis: inpatient No · outpatient No
CCSR END006
Diabetes mellitus, due to underlying condition, drug or chemical induced, or other specified type
Default principal diagnosis: inpatient No · outpatient No
CCSR EYE005
Retinal and vitreous conditions
Default principal diagnosis: inpatient No · outpatient No

Patient EducationClinical

Diabetes

Diabetes, also known as diabetes mellitus, is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your body's main source of energy. Your body can make glucose, but it also comes from the food you eat. Insulin is a hormone made by your pancreas.

The full article covers:

  • What is diabetes?
  • What are the types of diabetes?
  • What causes diabetes?
  • Who is more likely to develop diabetes?
  • What are the symptoms of diabetes?
  • How is diabetes diagnosed?
  • What are the treatments for diabetes?
  • Can diabetes be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert E08.311 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
249.50 Sec DM ophth nt st uncn
Approximate The match is approximate rather than exact.
ICD-9-CM
249.50 Sec DM ophth nt st uncn
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.
ICD-9-CM
362.01 Diabetic retinopathy NOS
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.
ICD-9-CM
362.07 Diabetic macular edema
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About E08.311Overview

Is E08.311 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does E08.311 group to?

On inpatient claims, diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema maps to MS-DRG 124, 125, with relative weights from 0.7678 to 1.3231 depending on complications. Higher weights mean higher Medicare reimbursement.

Can E08.311 be a principal diagnosis?

No. This is a manifestation code: diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema describes the manifestation of an underlying disease rather than the disease itself, so the underlying condition is sequenced first.

What is the ICD-9 equivalent of E08.311?

Under the General Equivalence Mappings, diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema converts to ICD-9-CM 249.50 (sec DM ophth nt st uncn), 249.50 (sec DM ophth nt st uncn), and 362.01 (diabetic retinopathy NOS). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.