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ICD-10 Guide
ICD-10 CodesE09.3212

E09.3212

Billable

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

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

Code Description

ICD-10 E09.3212 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema (left eye).

Key Diagnostic Point:

E09.3212 refers to diabetes mellitus that is induced by drugs or chemicals, characterized by the presence of mild nonproliferative diabetic retinopathy and macular edema specifically in the left eye. Drug-induced diabetes can occur due to various medications, including corticosteroids, antipsychotics, and certain chemotherapy agents. The condition is marked by elevated blood glucose levels, which can lead to long-term complications if not managed properly. Nonproliferative diabetic retinopathy is an early stage of diabetic eye disease where small blood vessels in the retina leak fluid, causing swelling and affecting vision. Macular edema, a common complication, occurs when fluid accumulates in the macula, leading to blurred vision. Management of this condition often involves controlling blood glucose levels through lifestyle changes, oral hypoglycemics, or insulin therapy, alongside monitoring and treating eye complications to prevent further vision loss.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of drug-induced diabetes mechanisms
  • Involves knowledge of diabetic retinopathy stages
  • Specificity in documenting eye conditions
  • Need for accurate differentiation from other diabetes types

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to specify the eye affected
  • Misclassification of retinopathy severity
  • Lack of supporting clinical evidence for diabetes diagnosis

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, HbA1c levels, and management plans.

Common Clinical Scenarios

Patients presenting with elevated glucose levels after starting new medications.

Billing Considerations

Ensure clear documentation of the relationship between medication and diabetes onset.

Ophthalmology

Documentation Requirements

Visual acuity tests, retinal examination findings, and treatment plans for retinopathy.

Common Clinical Scenarios

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

Billing Considerations

Document specific findings related to macular edema and its impact on vision.

Coding Guidelines

Inclusion Criteria

Use E09.3212 When
  • Follow ICD
  • CM guidelines for coding diabetes, ensuring to document the cause (drug
  • induced) and the specific complications (mild nonproliferative retinopathy with macular edema)
  • Include HbA1c levels to support the diagnosis

Exclusion Criteria

Do NOT use E09.3212 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 history, examination findings, and management plan.

Specialty Considerations

Endocrinology should document medication adjustments and HbA1c monitoring.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of diabetes types and complications, improving the accuracy of diabetes-related data and enhancing patient care management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetes types and complications, improving the accuracy of diabetes-related data and enhancing patient care management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of diabetes types and complications, improving the accuracy of diabetes-related data and enhancing patient care management.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What medications can induce diabetes?

Medications such as corticosteroids, certain antipsychotics, and some chemotherapy agents are known to induce diabetes by affecting insulin secretion or action.