ICD-10-CM Code E11.35

Type 2 diabetes mellitus with proliferative diabetic retinopathy

Version 2021 Non-Billable Code

Not Valid for Submission

E11.35 is a "header" nonspecific and non-billable code code, consider using a code with a higher level of specificity for a diagnosis of type 2 diabetes mellitus with proliferative diabetic retinopathy. The code is NOT valid for the year 2021 for the submission of HIPAA-covered transactions.

ICD-10:E11.35
Short Description:Type 2 diabetes w proliferative diabetic retinopathy
Long Description:Type 2 diabetes mellitus with proliferative diabetic retinopathy

Consider the following ICD-10 codes with a higher level of specificity:

  • E11.351 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema
  • E11.3511 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
  • E11.3512 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
  • E11.3513 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
  • E11.3519 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
  • E11.352 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula
  • E11.3521 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
  • E11.3522 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
  • E11.3523 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
  • E11.3529 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
  • E11.353 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula
  • E11.3531 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
  • E11.3532 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
  • E11.3533 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
  • E11.3539 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
  • E11.354 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
  • E11.3541 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
  • E11.3542 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
  • E11.3543 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
  • E11.3549 - Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
  • E11.355 - Type 2 diabetes mellitus with stable proliferative diabetic retinopathy
  • E11.3551 - Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
  • E11.3552 - Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
  • E11.3553 - Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
  • E11.3559 - Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye
  • E11.359 - Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema
  • E11.3591 - Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
  • E11.3592 - Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
  • E11.3593 - Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
  • E11.3599 - Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code E11.35:

7th Character Note

7th Character Note
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
  • One of the following 7th characters is to be assigned to codes in subcategory E11.35 to designate laterality of the disease:

7th Character

7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
  • 1 - right eye
  • 2 - left eye
  • 3 - bilateral
  • 9 - unspecified eye

Code Classification

  • Endocrine, nutritional and metabolic diseases (E00–E90)
    • Diabetes mellitus (E08-E13)
      • Type 2 diabetes mellitus (E11)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021

Information for Patients


Diabetes Type 2

Also called: Type 2 Diabetes

Diabetes means your blood glucose, or blood sugar, levels are too high. With type 2 diabetes, the more common type, your body does not make or use insulin well. 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.

You have a higher risk of type 2 diabetes if you are older, have obesity, have a family history of diabetes, or do not exercise. Having prediabetes also increases your risk. Prediabetes means that your blood sugar is higher than normal but not high enough to be called diabetes. If you are at risk for type 2 diabetes, you may be able to delay or prevent developing it by making some lifestyle changes.

The symptoms of type 2 diabetes appear slowly. Some people do not notice symptoms at all. The symptoms can include

  • Being very thirsty
  • Urinating often
  • Feeling very hungry or tired
  • Losing weight without trying
  • Having sores that heal slowly
  • Having blurry eyesight

Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Many people can manage their diabetes through healthy eating, physical activity, and blood glucose testing. Some people also need to take diabetes medicines.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

  • A1C test (Medical Encyclopedia)
  • Diabetes type 2 - meal planning (Medical Encyclopedia)
  • Giving an insulin injection (Medical Encyclopedia)
  • High blood sugar - self-care (Medical Encyclopedia)
  • Type 2 diabetes (Medical Encyclopedia)
  • Type 2 diabetes - self-care (Medical Encyclopedia)

[Learn More]

Diabetic Eye Problems

Also called: Diabetic retinopathy

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can damage your eyes. The most common problem is diabetic retinopathy. It is a leading cause of blindness in American adults.

Your retina is the light-sensitive tissue at the back of your eye. You need a healthy retina to see clearly. Diabetic retinopathy damages the tiny blood vessels inside your retina.

You may not notice it at first. Symptoms can include

  • Blurry or double vision
  • Rings, flashing lights, or blank spots
  • Dark or floating spots
  • Pain or pressure in one or both of your eyes
  • Trouble seeing things out of the corners of your eyes

Treatment often includes laser treatment or surgery, with follow-up care.

Two other eye problems can happen to people with diabetes. A cataract is a cloud over the lens of your eye. Surgery helps you see clearly again. Glaucoma happens when pressure builds up in the eye, damaging the main nerve. Eye drops or surgery can help.

If you have diabetes, you should have a complete eye exam every year. Finding and treating problems early may save your vision.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

  • Diabetes - eye care (Medical Encyclopedia)
  • Diabetes and eye disease (Medical Encyclopedia)
  • Diabetes eye exams (Medical Encyclopedia)
  • Fluorescein angiography (Medical Encyclopedia)
  • Intravitreal injection (Medical Encyclopedia)
  • Laser photocoagulation -- eye (Medical Encyclopedia)
  • Standard ophthalmic exam (Medical Encyclopedia)

[Learn More]

Type 2 diabetes Type 2 diabetes is a disorder characterized by abnormally high blood sugar levels. In this form of diabetes, the body stops using and making insulin properly. Insulin is a hormone produced in the pancreas that helps regulate blood sugar levels. Specifically, insulin controls how much glucose (a type of sugar) is passed from the blood into cells, where it is used as an energy source. When blood sugar levels are high (such as after a meal), the pancreas releases insulin to move the excess glucose into cells, which reduces the amount of glucose in the blood.Most people who develop type 2 diabetes first have insulin resistance, a condition in which the body's cells use insulin less efficiently than normal. As insulin resistance develops, more and more insulin is needed to keep blood sugar levels in the normal range. To keep up with the increasing need, insulin-producing cells in the pancreas (called beta cells) make larger amounts of insulin. Over time, the beta cells become less able to respond to blood sugar changes, leading to an insulin shortage that prevents the body from reducing blood sugar levels effectively. Most people have some insulin resistance as they age, but inadequate exercise and excessive weight gain make it worse, greatly increasing the likelihood of developing type 2 diabetes.Type 2 diabetes can occur at any age, but it most commonly begins in middle age or later. Signs and symptoms develop slowly over years. They include frequent urination (polyuria), excessive thirst (polydipsia), fatigue, blurred vision, tingling or loss of feeling in the hands and feet (diabetic neuropathy), sores that do not heal well, and weight loss. If blood sugar levels are not controlled through medication or diet, type 2 diabetes can cause long-lasting (chronic) health problems including heart disease and stroke; nerve damage; and damage to the kidneys, eyes, and other parts of the body.
[Learn More]