2022 ICD-10-CM Code E13.3

Other specified diabetes mellitus with ophthalmic complications

Version 2021

Not Valid for Submission

ICD-10:E13.3
Short Description:Oth diabetes mellitus with ophthalmic complications
Long Description:Other specified diabetes mellitus with ophthalmic complications

Code Classification

  • Endocrine, nutritional and metabolic diseases (E00–E90)
    • Diabetes mellitus (E08-E13)
      • Other specified diabetes mellitus (E13)

E13.3 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of other specified diabetes mellitus with ophthalmic complications. The code is not specific and is NOT valid for the year 2022 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

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.

Specific Coding for Oth diabetes mellitus with ophthalmic complications

Non-specific codes like E13.3 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for oth diabetes mellitus with ophthalmic complications:

  • NON-BILLABLE CODE - E13.31 for Other specified diabetes mellitus with unspecified diabetic retinopathy
  • BILLABLE CODE - Use E13.311 for Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema
  • BILLABLE CODE - Use E13.319 for Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema
  • NON-BILLABLE CODE - E13.32 for Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy
  • NON-BILLABLE CODE - E13.321 for Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema
  • BILLABLE CODE - Use E13.3211 for right eye
  • BILLABLE CODE - Use E13.3212 for left eye
  • BILLABLE CODE - Use E13.3213 for bilateral
  • BILLABLE CODE - Use E13.3219 for unspecified eye
  • NON-BILLABLE CODE - E13.329 for Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema
  • BILLABLE CODE - Use E13.3291 for right eye
  • BILLABLE CODE - Use E13.3292 for left eye
  • BILLABLE CODE - Use E13.3293 for bilateral
  • BILLABLE CODE - Use E13.3299 for unspecified eye
  • NON-BILLABLE CODE - E13.33 for Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy
  • NON-BILLABLE CODE - E13.331 for Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
  • BILLABLE CODE - Use E13.3311 for right eye
  • BILLABLE CODE - Use E13.3312 for left eye
  • BILLABLE CODE - Use E13.3313 for bilateral
  • BILLABLE CODE - Use E13.3319 for unspecified eye
  • NON-BILLABLE CODE - E13.339 for Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema
  • BILLABLE CODE - Use E13.3391 for right eye
  • BILLABLE CODE - Use E13.3392 for left eye
  • BILLABLE CODE - Use E13.3393 for bilateral
  • BILLABLE CODE - Use E13.3399 for unspecified eye
  • NON-BILLABLE CODE - E13.34 for Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy
  • NON-BILLABLE CODE - E13.341 for Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema
  • BILLABLE CODE - Use E13.3411 for right eye
  • BILLABLE CODE - Use E13.3412 for left eye
  • BILLABLE CODE - Use E13.3413 for bilateral
  • BILLABLE CODE - Use E13.3419 for unspecified eye
  • NON-BILLABLE CODE - E13.349 for Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema
  • BILLABLE CODE - Use E13.3491 for right eye
  • BILLABLE CODE - Use E13.3492 for left eye
  • BILLABLE CODE - Use E13.3493 for bilateral
  • BILLABLE CODE - Use E13.3499 for unspecified eye
  • NON-BILLABLE CODE - E13.35 for Other specified diabetes mellitus with proliferative diabetic retinopathy
  • NON-BILLABLE CODE - E13.351 for Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema
  • BILLABLE CODE - Use E13.3511 for right eye
  • BILLABLE CODE - Use E13.3512 for left eye
  • BILLABLE CODE - Use E13.3513 for bilateral
  • BILLABLE CODE - Use E13.3519 for unspecified eye
  • NON-BILLABLE CODE - E13.352 for Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula
  • BILLABLE CODE - Use E13.3521 for right eye
  • BILLABLE CODE - Use E13.3522 for left eye
  • BILLABLE CODE - Use E13.3523 for bilateral
  • BILLABLE CODE - Use E13.3529 for unspecified eye
  • NON-BILLABLE CODE - E13.353 for Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula
  • BILLABLE CODE - Use E13.3531 for right eye
  • BILLABLE CODE - Use E13.3532 for left eye
  • BILLABLE CODE - Use E13.3533 for bilateral
  • BILLABLE CODE - Use E13.3539 for unspecified eye
  • NON-BILLABLE CODE - E13.354 for Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
  • BILLABLE CODE - Use E13.3541 for right eye
  • BILLABLE CODE - Use E13.3542 for left eye
  • BILLABLE CODE - Use E13.3543 for bilateral
  • BILLABLE CODE - Use E13.3549 for unspecified eye
  • NON-BILLABLE CODE - E13.355 for Other specified diabetes mellitus with stable proliferative diabetic retinopathy
  • BILLABLE CODE - Use E13.3551 for right eye
  • BILLABLE CODE - Use E13.3552 for left eye
  • BILLABLE CODE - Use E13.3553 for bilateral
  • BILLABLE CODE - Use E13.3559 for unspecified eye
  • NON-BILLABLE CODE - E13.359 for Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema
  • BILLABLE CODE - Use E13.3591 for right eye
  • BILLABLE CODE - Use E13.3592 for left eye
  • BILLABLE CODE - Use E13.3593 for bilateral
  • BILLABLE CODE - Use E13.3599 for unspecified eye
  • BILLABLE CODE - Use E13.36 for Other specified diabetes mellitus with diabetic cataract
  • NON-BILLABLE CODE - E13.37 for Other specified diabetes mellitus with diabetic macular edema, resolved following treatment
  • BILLABLE CODE - Use E13.37X1 for right eye
  • BILLABLE CODE - Use E13.37X2 for left eye
  • BILLABLE CODE - Use E13.37X3 for bilateral
  • BILLABLE CODE - Use E13.37X9 for unspecified eye
  • BILLABLE CODE - Use E13.39 for Other specified diabetes mellitus with other diabetic ophthalmic complication

Information for Patients


Diabetes

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes.

Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes.

Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your blood glucose level and take medicine if prescribed.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases


[Learn More in MedlinePlus]

Diabetic Eye Problems

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

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


[Learn More in MedlinePlus]

Code History

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