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ICD-10 Guide
ICD-10 CodesE09.311

E09.311

Billable

Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 E09.311 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema.

Key Diagnostic Point:

E09.311 refers to diabetes mellitus that is induced by drugs or chemicals, leading to complications such as diabetic retinopathy characterized by macular edema. This condition arises when certain medications or toxic substances disrupt normal glucose metabolism, resulting in elevated blood sugar levels. The presence of diabetic retinopathy indicates damage to the retinal blood vessels, which can lead to vision impairment. Macular edema, a common complication, occurs when fluid accumulates in the macula, the central part of the retina responsible for sharp vision. Patients may experience blurred vision, difficulty reading, or other visual disturbances. Management of this condition typically involves controlling blood glucose levels through insulin therapy or oral hypoglycemic agents, monitoring HbA1c levels to assess long-term glucose control, and addressing the retinopathy through ophthalmologic interventions. Regular follow-up and comprehensive care are essential to prevent further complications and preserve vision.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between drug-induced diabetes and other types of diabetes
  • Identifying and documenting the specific drug or chemical responsible
  • Understanding the nuances of diabetic retinopathy and its stages
  • Managing multiple complications associated with diabetes

Audit Risk Factors

  • Inadequate documentation of the drug or chemical causing diabetes
  • Failure to document the severity of diabetic retinopathy
  • Lack of follow-up documentation regarding treatment and management
  • Misclassification of the type of diabetes

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, HbA1c levels, and management plans.

Common Clinical Scenarios

Patients presenting with new-onset diabetes after starting a specific medication.

Billing Considerations

Ensure clarity on the relationship between the drug and diabetes onset.

Ophthalmology

Documentation Requirements

Visual acuity tests, retinal imaging results, and treatment plans for retinopathy.

Common Clinical Scenarios

Patients with diabetes presenting for routine eye exams showing signs of retinopathy.

Billing Considerations

Document the extent of retinopathy and any interventions performed.

Coding Guidelines

Inclusion Criteria

Use E09.311 When
  • According to ICD
  • 10 guidelines, E09
  • 311 should be used when diabetes is specifically induced by drugs or chemicals, and there is evidence of diabetic retinopathy with macular edema
  • Documentation must clearly indicate the cause and the complications

Exclusion Criteria

Do NOT use E09.311 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for diabetes management.

Documentation Requirements

Document patient's diabetes management plan and any complications.

Specialty Considerations

Endocrinologists should ensure comprehensive diabetes management documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of drug-induced diabetes, improving the accuracy of diabetes-related data and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of drug-induced diabetes, improving the accuracy of diabetes-related data and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of drug-induced diabetes, improving the accuracy of diabetes-related data and facilitating better patient management.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What types of drugs can induce diabetes mellitus?

Common drugs that can induce diabetes include corticosteroids, certain antipsychotics, and some antihypertensive medications. It is important to document the specific medication responsible for accurate coding.