E10.3413 - Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral

Version 2023
ICD-10:E10.3413
Short Description:Type 1 diab with severe nonp rtnop with macular edema, bi
Long Description:Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
Status: Valid for Submission
Version:ICD-10-CM 2023
Code Classification:
  • Endocrine, nutritional and metabolic diseases (E00–E90)
    • Diabetes mellitus (E08-E13)
      • Type 1 diabetes mellitus (E10)

E10.3413 is a billable ICD-10 code used to specify a medical diagnosis of type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral. The code is valid during the fiscal year 2023 from October 01, 2022 through September 30, 2023 for the submission of HIPAA-covered transactions.

The code is linked to some Quality Measures as part of Medicare's Quality Payment Program (QPP). When this code is used as part of a patient's medical record the following Quality Measures might apply: Diabetes: Hemoglobin A1c (hba1c) Poor Control (>9%) , Diabetes: Eye Exam.

Coding Guidelines

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.

The age of a patient is not the sole determining factor, though most type 1 diabetics develop the condition before reaching puberty. For this reason type 1 diabetes mellitus is also referred to as juvenile diabetes.

Replacement Code

E103413 replaces the following previously assigned ICD-10 code(s):

Convert to ICD-9 Code

Source ICD-10 CodeTarget ICD-9 Code
E10.3413250.51 - DMI ophth nt st uncntrld
Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.
E10.3413362.06 - Sev nonprolf db retinoph
Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.
E10.3413362.07 - Diabetic macular edema
Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.

Quality Payment Program Measures

When code E10.3413 is part of the patient's diagnoses the following Quality Measures apply and affect reimbursement. The objective of Medicare's Quality Measures is to improve patient care by making it more: effective, safe, efficient, patient-centered and equitable.

Quality Measure Description Quality Domain Measure Type High Priority Submission Methods
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period.Effective Clinical CareIntermediateoutcomeYESClaims, Electronichealthrecord, Cmswebinterface, Registry
Diabetes: Eye ExamPercentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy overlapping the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy overlapping the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period.Effective Clinical CareProcessNOClaims, Electronichealthrecord, Registry

Patient Education


Diabetes Type 1

Diabetes means your blood glucose, or blood sugar, levels are too high. With type 1 diabetes, your pancreas does not make insulin. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, and gums and teeth.

Type 1 diabetes happens most often in children and young adults but can appear at any age. Symptoms may include:

A blood test can show if you have diabetes. If you do, you will need to take insulin for the rest of your life. A blood test called the A1C can check to see how well you are managing your diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases


[Learn More in MedlinePlus]

Diabetic Eye Problems

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood sugar levels.

What eye problems can diabetes cause?

Over time, high blood sugar may damage the blood vessels and lenses in your eyes. This can lead to serious diabetic eye problems which can harm your vision and sometimes cause blindness. Some common diabetes eye problems include:

Who is more likely to develop diabetic eye problems?

Anyone with diabetes can develop diabetic eye disease. But your risk of developing it is higher if you:

What are the symptoms of diabetic eye problems?

In the early stages, diabetic eye problems usually don't have any symptoms. That's why regular dilated eye exams are so important, even if you think your eyes are healthy.

You should also watch for sudden changes in your vision that could mean an emergency. Call your doctor right away if you notice any of these symptoms:

Talk with your doctor if you have these symptoms, even if they come and go:

How are diabetic eye problems diagnosed?

Eye doctors do dilated eye exams to diagnose eye problems. A dilated eye exam uses eye drops to open your pupils wide so your doctor can look for signs of eye problems and treat them before they harm your vision. Your doctor will also test your vision and measure the pressure in your eyes.

What are the treatments for diabetic eye problems?

Treatment for diabetic eye problems depends on the problem and how serious it is. Some of the treatments include:

But these treatments aren't cures. Eye problems can come back. That's why your best defense against serious vision loss is to take control of your diabetes and get regular eye exams. It's also important to keep your blood pressure and cholesterol in a healthy range.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases


[Learn More in MedlinePlus]

Diabetic Eye Disease

Learn about diabetes and eye disease; symptoms, warning signs, and treatments; and how you can prevent eye disease—or keep it from getting worse.
[Learn More in MedlinePlus]

Code History