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ICD-10 Guide
ICD-10 CodesE09.3219

E09.3219

Billable

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

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

Code Description

ICD-10 E09.3219 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema (unspecified eye).

Key Diagnostic Point:

E09.3219 refers to diabetes mellitus that is induced by drugs or chemicals, characterized by the presence of mild nonproliferative diabetic retinopathy and macular edema in an unspecified 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 mild nonproliferative diabetic retinopathy indicates early changes in the retina due to diabetes, including microaneurysms and retinal hemorrhages, while macular edema signifies fluid accumulation in the macula, potentially affecting vision. Management of this condition typically involves controlling blood glucose levels through lifestyle modifications, oral hypoglycemic agents, or insulin therapy, alongside monitoring and treating the ocular complications to prevent 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
  • Need for precise documentation of ocular findings
  • Differentiation from other types of diabetes

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to specify the type of retinopathy
  • Lack of evidence for macular edema diagnosis
  • Misclassification of diabetes type

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, HbA1c levels, and management plans.

Common Clinical Scenarios

Patients presenting with elevated blood glucose levels after starting new medications.

Billing Considerations

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

Ophthalmology

Documentation Requirements

Comprehensive eye examination findings, including retinal imaging results.

Common Clinical Scenarios

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

Billing Considerations

Document the severity of retinopathy and any treatment provided for macular edema.

Coding Guidelines

Inclusion Criteria

Use E09.3219 When
  • Follow ICD
  • CM guidelines for coding diabetes, ensuring to document the cause (drug
  • induced) and the complications (retinopathy and macular edema)
  • Include HbA1c levels and treatment plans in the documentation

Exclusion Criteria

Do NOT use E09.3219 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 thorough documentation of diabetes control and retinopathy assessment.

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 and its complications, improving the accuracy of patient records and facilitating better management of these conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of drug-induced diabetes and its complications, improving the accuracy of patient records and facilitating better management of these conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of drug-induced diabetes and its complications, improving the accuracy of patient records and facilitating better management of these conditions.

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 thiazide diuretics are known to induce diabetes by affecting insulin sensitivity or secretion.