E13.331 – Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema

ICD-10-CM 2027 diagnosis code · Diabetes mellitus

Non-billable header

ICD-10-CM code E13.331

Code: E13.331 (claims format: E13331)
Description: Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
Short description: Oth diab w moderate nonprlf diabetic rtnop w macular edema
Billable: No – use a more specific code below
Valid for: Dates of service October 1, 2026 – September 30, 2027 (FY2027)
Chapter: 4. Endocrine, nutritional and metabolic diseases (E00-E89)
Block: E08-E13 Diabetes mellitus
Parent codes: E13 › E13.3 › E13.33

Billable codes under E13.331

E13.331 is a header code and cannot be used on claims. Choose the most specific code:

7th character values

Codes in this category need a 7th character to describe the encounter or episode of care.

Character	Meaning
`1`	right eye
`2`	left eye
`3`	bilateral
`9`	unspecified eye

Notes inherited from parent codes

Instructional notes at a category or block level apply to every code below it.

E13 – Other specified diabetes mellitus

Includes:

diabetes mellitus due to genetic defects of beta-cell function
diabetes mellitus due to genetic defects in insulin action
postpancreatectomy diabetes mellitus
postprocedural diabetes mellitus
secondary diabetes mellitus NEC

Excludes1 (not coded here):

diabetes (mellitus) due to autoimmune process (E10.-)
diabetes (mellitus) due to immune mediated pancreatic islet beta-cell destruction (E10.-)
diabetes mellitus due to underlying condition (E08.-)
drug or chemical induced diabetes mellitus (E09.-)
gestational diabetes (O24.4-)
neonatal diabetes mellitus (P70.2)
type 1 diabetes mellitus (E10.-)

Use additional code:

code to identify control using:
injectable non-insulin antidiabetic drugs (Z79.85)
insulin (Z79.4)
oral antidiabetic drugs (Z79.84)
oral hypoglycemic drugs (Z79.84)

E13.33 – Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy

7th character note:

One of the following 7th characters is to be assigned to codes in subcategory E13.33 to designate laterality of the disease:

Index terms for E13.331

Entries in the ICD-10-CM alphabetic index that lead to this code:

Diabetes, diabetic, specified type NEC, with, retinopathy, nonproliferative, moderate, with macular edema

Related codes in E13.33

E13.339 – Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edemaHeader

Frequently asked questions

What is ICD-10 code E13.331?

E13.331 is the ICD-10-CM code for other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, in the block E08-E13 (Diabetes mellitus).

Is E13.331 a billable code?

No. E13.331 is a header code with more specific child codes; report one of the billable codes listed above.

What category does E13.331 belong to?

It belongs to category E13 – Other specified diabetes mellitus.

Source: CDC/NCHS ICD-10-CM FY2027 code files, tabular list and index. Reference only – code assignment must follow the official ICD-10-CM guidelines and documentation in the medical record.