ICD-10 E11.311
Billable / SpecificType 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema
About ICD-10-CM E11.311
ICD-10-CM code E11.311 represents Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E11). The 2026 edition of ICD-10-CM E11.311 became effective on October 1, 2025.
Medicare LCD Coverage for E11.311
Local Coverage Determinations (LCDs) from CMS MACs that list E11.311 as a covered diagnosis.
Showing top 10 of 299 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E11.311.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with E11.311
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 67028 Intravitreal injection — wet AMD, macular degeneration, diabetic macular edema, diabetic retinopathy, retinal vein occlusion Ophthalmology
- 67028 Intravitreal injection — wet/dry AMD all stages both eyes, diabetic macular edema, diabetic retinopathy, retinal vein occlusion, macular edema Ophthalmology
- 43645 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43888 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43845 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43848 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43772 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43659 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43644 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
- 43774 CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity CMS LCD
Convert E11.311 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| E11.311 | 25050 | 10111 |
| E11.311 | 36201 | 10112 |
| E11.311 | 36207 | 10113 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E11.311
Other codes in section E08-E13 (Diabetes mellitus).
ICD-10 E11.311, Billing FAQ
Is ICD-10 code E11.311 billable? +
Yes, E11.311 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What CPT codes are commonly billed with E11.311? +
Procedures frequently paired with E11.311 include: 67028, 67028, 43645, 43888, 43845.
What ICD-9 codes does E11.311 map to? +
Per CMS GEMs, E11.311 maps to ICD-9 codes: 25050, 36201, 36207. Useful for legacy data review and historical claim analysis.
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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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