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ICD-10 Guide
ICD-10 CodesE09.33

E09.33

Billable

Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy

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

Code Description

ICD-10 E09.33 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy.

Key Diagnostic Point:

E09.33 refers to diabetes mellitus that has been induced by drugs or chemicals, characterized by the presence of moderate nonproliferative diabetic retinopathy. This condition arises when certain medications or toxic substances lead to insulin resistance or impaired insulin secretion, resulting in elevated blood glucose levels. Nonproliferative diabetic retinopathy is a common complication of diabetes, where damage occurs to the retinal blood vessels, leading to vision problems. Moderate nonproliferative diabetic retinopathy is defined by the presence of microaneurysms, retinal hemorrhages, and exudates, but without the growth of new blood vessels (neovascularization). Management of this condition often involves controlling blood glucose levels through lifestyle modifications, oral hypoglycemic agents, or insulin therapy, alongside regular ophthalmologic evaluations to monitor retinal health. The HbA1c levels in patients with drug-induced diabetes can vary, but maintaining levels below 7% is generally recommended to prevent complications. Understanding the underlying cause of diabetes, particularly in cases induced by medications, is crucial for effective treatment and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Identification of the specific drug or chemical causing diabetes
  • Differentiation from other types of diabetes mellitus
  • Documentation of retinopathy severity
  • Management of multiple complications

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to specify the type of retinopathy
  • Incorrect coding of diabetes type
  • Lack of follow-up documentation for retinopathy

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 clear documentation of the drug responsible for diabetes and its management.

Ophthalmology

Documentation Requirements

Retinal examination findings, grading of retinopathy severity, and treatment plans.

Common Clinical Scenarios

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

Billing Considerations

Document the relationship between diabetes management and retinal health.

Coding Guidelines

Inclusion Criteria

Use E09.33 When
  • According to ICD
  • 10 guidelines, E09
  • 33 should be used when diabetes is specifically induced by drugs or chemicals, and moderate nonproliferative diabetic retinopathy is present
  • It is essential to document the specific drug or chemical and the severity of retinopathy

Exclusion Criteria

Do NOT use E09.33 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

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.

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 corticosteroids, certain antipsychotics, and some antihypertensive agents. It is essential to review the patient's medication history to identify potential causes.