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ICD-10 Guide
ICD-10 CodesE09.3211

E09.3211

Billable

Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema (right eye)

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

Code Description

ICD-10 E09.3211 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema (right eye).

Key Diagnostic Point:

E09.3211 refers to diabetes mellitus that is induced by drugs or chemicals, specifically characterized by mild nonproliferative diabetic retinopathy with macular edema in the right eye. This condition arises when certain medications, such as corticosteroids or antipsychotics, lead to insulin resistance or impaired insulin secretion, resulting in elevated blood glucose levels. The presence of mild nonproliferative diabetic retinopathy indicates early changes in the retina due to diabetes, where small blood vessels may leak fluid, leading to macular edema, which can affect vision. Management of this condition typically involves controlling blood glucose levels through lifestyle modifications, oral hypoglycemic agents, or insulin therapy, while also addressing the ocular complications through regular ophthalmologic evaluations and potential treatments such as laser therapy or anti-VEGF injections. Regular monitoring of HbA1c levels is crucial to assess long-term glycemic control and prevent further complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of drug-induced diabetes mechanisms
  • Involves knowledge of diabetic retinopathy stages
  • Need for precise documentation of ocular findings
  • Management of multiple conditions (diabetes and retinopathy)

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to specify the type of retinopathy
  • Lack of clear linkage between diabetes and ocular findings
  • Inconsistent HbA1c documentation

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, HbA1c levels, and management plans.

Common Clinical Scenarios

Patients with diabetes management issues due to medication changes.

Billing Considerations

Ensure clear documentation of drug-induced nature and its impact on diabetes control.

Ophthalmology

Documentation Requirements

Ocular examination findings, including retinal imaging results.

Common Clinical Scenarios

Patients presenting with vision changes related to diabetic retinopathy.

Billing Considerations

Document the severity of retinopathy and any treatments administered.

Coding Guidelines

Inclusion Criteria

Use E09.3211 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the cause of diabetes and associated complications
  • Include specific details about the type of retinopathy and any treatments provided

Exclusion Criteria

Do NOT use E09.3211 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination

Clinical Scenario

Used for routine eye exams in diabetic patients.

Documentation Requirements

Document visual acuity, retinal findings, and any treatments.

Specialty Considerations

Ensure linkage to diabetes diagnosis for proper billing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of diabetes types and complications, improving the accuracy of patient records and reimbursement processes. E09.3211 provides a clear framework for documenting drug-induced diabetes and its ocular complications.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of diabetes types and complications, improving the accuracy of patient records and reimbursement processes. E09.3211 provides a clear framework for documenting drug-induced diabetes and its ocular complications.

Reimbursement & Billing Impact

reimbursement processes. E09.3211 provides a clear framework for documenting drug-induced diabetes and its ocular complications.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What medications can induce diabetes mellitus?

Common medications include corticosteroids, thiazide diuretics, and certain antipsychotics, which can lead to insulin resistance or impaired insulin secretion.