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ICD-10 Guide
ICD-10 CodesE09.319

E09.319

Billable

Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy without macular edema

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

Code Description

ICD-10 E09.319 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy without macular edema.

Key Diagnostic Point:

E09.319 refers to diabetes mellitus that has been induced by drugs or chemicals, characterized by the presence of unspecified diabetic retinopathy without macular edema. This condition arises when certain medications or toxic substances disrupt normal glucose metabolism, leading to hyperglycemia and subsequent diabetes. The retinopathy associated with this code indicates damage to the retinal blood vessels, which can occur even in the absence of macular edema, a more severe form of diabetic eye disease. Patients may present with varying degrees of visual impairment, and management typically involves controlling blood glucose levels to prevent further retinal damage. Regular eye examinations are crucial for early detection and management of retinopathy. The condition necessitates a multidisciplinary approach, including endocrinology for diabetes management and ophthalmology for eye health monitoring.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Identification of the specific drug or chemical causing diabetes.
  • Differentiation between types of diabetic retinopathy.
  • Assessment of the absence of macular edema.
  • Need for comprehensive documentation of diabetes management.

Audit Risk Factors

  • Inadequate documentation of drug or chemical exposure.
  • Failure to specify the type of diabetic retinopathy.
  • Lack of evidence for the absence of macular edema.
  • Insufficient follow-up documentation on diabetes management.

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 new medication.

Billing Considerations

Close monitoring of blood glucose levels and potential adjustments in diabetes management.

Ophthalmology

Documentation Requirements

Comprehensive eye examination reports, including retinal imaging.

Common Clinical Scenarios

Patients with diabetes presenting for routine eye exams or with visual complaints.

Billing Considerations

Documentation of retinopathy findings and correlation with diabetes management.

Coding Guidelines

Inclusion Criteria

Use E09.319 When
  • According to ICD
  • 10 guidelines, E09
  • 319 should be used when diabetes is specifically induced by drugs or chemicals, and the documentation must support the diagnosis of diabetic retinopathy without macular edema
  • It is essential to ensure that the retinopathy is not classified as proliferative or associated with macular edema

Exclusion Criteria

Do NOT use E09.319 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 changes in medication.

Specialty Considerations

Endocrinologists should ensure comprehensive documentation of diabetes control.

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 and research.

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 and research.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What types of drugs can induce diabetes mellitus?

Several classes of medications can induce diabetes, including glucocorticoids, certain antipsychotics, and some antihypertensives. It is essential to review the patient's medication history to identify potential causes.