2026 ICD-10-CM Diagnosis Code E11.36Type 2 diabetes mellitus with diabetic cataract
ICD-10-CM Codes›E00–E89›E08-E13›E11
- Billable — Valid for Submission
- Chronic Condition
E11.36 is a billable ICD-10-CM diagnosis code for type 2 diabetes mellitus with diabetic cataract. 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. Coders also document this condition as cataract due to diabetes mellitus. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cataract and other lens disorders; Diabetes mellitus with complication; and Diabetes mellitus, Type 2.
This medical diagnosis code is frequently used in Family Practice medical specialties to designate conditions such diabetes mellitus with complications type 2.
Code Identity
Code Classification
Quality Payment Program MeasuresBilling
Medicare quality measures that can apply when E11.36 is part of the patient record.
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
High Priority: YES
Measure Type: Intermediateoutcome
Submission Methods: Claims, Electronic Health Record, Cms Web Interface, Registry
Description: Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Cataract due to diabetes mellitus
- Cataract due to diabetes mellitus type 2
- Cataract of left eye due to diabetes mellitus
- Cataract of right eye due to diabetes mellitus
- Diabetic cataract of bilateral eyes
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.
If the type of diabetes mellitus is not documented in the medical record the default is E11.-, Type 2 diabetes mellitus.
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
External Cause of Injuries IndexGuidance
References for this code in the External Cause of Injuries Index.
- Diabetes, diabetic(mellitus) (sugar)
- with
- cataract
- Diabetes, diabetic(mellitus) (sugar)
- type 2
- with
- cataract
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Cataract
A cataract is a clouding of the lens in your eye. It affects your vision. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert E11.36 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About E11.36Overview
Is E11.36 (Type 2 diabetes mellitus with ophthalmic complications) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report type 2 diabetes mellitus with diabetic cataract on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does E11.36 group to?
When type 2 diabetes mellitus with diabetic cataract is the principal diagnosis on an inpatient stay, it groups to MS-DRG 124, 125, with relative weights from 0.7678 to 1.3231 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of E11.36?
Under the General Equivalence Mappings, type 2 diabetes mellitus with diabetic cataract converts to ICD-9-CM 250.50 (DMII ophth nt st uncntrl) and 366.41 (diabetic cataract). 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.
