ICD-10 E09.35
Non-Billable HeaderDrug or chemical induced diabetes mellitus with proliferative diabetic retinopathy
About ICD-10-CM E09.35
ICD-10-CM code E09.35 represents Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy. This is a non-billable header code in the Endocrine, Nutritional, and Metabolic chapter (block E09). The 2026 edition of ICD-10-CM E09.35 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Coding Notes
Seven Chr Note
- One of the following 7th characters is to be assigned to codes in subcategory E09.35 to designate laterality of the disease:
Medicare LCD Coverage for E09.35
Local Coverage Determinations (LCDs) from CMS MACs that list E09.35 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E09.35.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but E09.35 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with E09.35
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To E09.35
Other codes in section E08-E13 (Diabetes mellitus).
ICD-10 E09.35, Billing FAQ
Is ICD-10 code E09.35 billable? +
No, E09.35 is a non-billable header code. Use a more specific child code from block E09 when submitting claims.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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