(Medicare Claims Processing Manual)

E11.9  Type 2 diabetes mellitus without complications  E13.9  Other specified diabetes mellitus without complications  E11.65  Type 2 diabetes mellitus with hyperglycemia  E13.10  Other specified diabetes mellitus with ketoacidosis without coma  E11.69  Type 2 diabetes mellitus with other specified complication   Note: E11.69 with E11.65 are a cluster BUT since each code on its own justifies the service, the combination is not required together for this policy.  E11.00  Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic -hyperosmolar coma (NKHHC)  E11.01  Type 2 diabetes mellitus with hyperosmolarity with coma  E13.00  Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic -hyperosmolar coma (NKHHC)  E13.01  Other specified diabetes mellitus with hyperosmolarity with coma   Note: E11.00 with E11.65 are a cluster BUT since each code on its own justifies the service, the combination is not required together for this policy.  E11.641  Type 2 diabetes mellitus with hypoglycemia with coma  E13.11  Other specified diabetes mellitus with ketoacidosis with coma  E13.641  Other specified diabetes mellitus with hypoglycemia with coma   Note: E11.01 with E11.65 are a cluster BUT since each code on its own justifies the service, the combination is not required together for this policy.  E11.21  Type 2 diabetes mellitus with diabetic nephropathy  E11.22  Type 2 diabetes mellitus with diabetic chronic kidney disease  E11.29  Type 2 diabetes mellitus with other diabetic kidney complication  E13.21  Other specified diabetes mellitus with diabetic nephropathy  E13.22  Other specified diabetes mellitus with diabetic chronic kidney disease  E13.29  Other specified diabetes mellitus with other diabetic kidney complication   Note: E11.21 with E11.65 are a cluster BUT since each code on its own justifies the service, the combination is not required together for this policy.  E11.3211  Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye  E11.3212  Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye  E11.3213  Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral  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  E11.37X1  Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye  E11.37X2  Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye  E11.37X3  Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral  E11.3291  Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye  E11.3292  Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye  E11.3293  Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral  E11.3311  Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye  E11.3312  Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye  E11.3313  Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral  E11.3391  Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye  E11.3392  Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye  E11.3393  Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral  E11.3411  Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye  E11.3412  Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye  E11.3413  Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral  E11.3491  Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye  E11.3492  Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye  E11.3493  Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral  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  E11.3521  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  E11.3531  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  E11.3591  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  E11.37X1  Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye  E11.37X2  Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye  E11.37X3  Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral  E13.311  Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema  E13.319  Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema  E13.3211  Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye  E13.3212  Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye  E13.3213  Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral  E13.3291  Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye  E13.3292  Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye  E13.3293  Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral  E13.3311  Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye  E13.3312  Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye  E13.3313  Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral  E13.3391  Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye  E13.3392  Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye  E13.3393  Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral  E13.3411  Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye  E13.3412  Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye  E13.3413  Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral  E13.3491  Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye  E13.3492  Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye  E13.3493  Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral  E13.3511  Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye  E13.3512  Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye  E13.3513  Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral  E13.3521  Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye  E13.3522  Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye  E13.3523  Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral  E13.3531  Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye  E13.3532  Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye  E13.3533  Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral  E13.3541  Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye  E13.3542  Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye  E13.3543  Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral  E13.3551  Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye  E13.3552  Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left eye  E13.3553  Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral  E13.3591  Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye  E13.3592  Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye  E13.3593  Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral  E13.36  Other specified diabetes mellitus with diabetic cataract  E13.39  Other specified