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ICD-10 Guide
ICD-10 CodesE09.3319

E09.3319

Billable

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

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

Code Description

ICD-10 E09.3319 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema (unspecified eye).

Key Diagnostic Point:

E09.3319 refers to diabetes mellitus that is induced by drugs or chemicals, characterized by moderate nonproliferative diabetic retinopathy with macular edema in an unspecified eye. This condition arises when certain medications or substances lead to insulin resistance or impaired insulin secretion, resulting in elevated blood glucose levels. The presence of moderate nonproliferative diabetic retinopathy indicates changes in the retinal blood vessels, which can lead to vision complications. Macular edema, a common complication of diabetic retinopathy, occurs when fluid accumulates in the macula, affecting central vision. Management of this condition often involves controlling blood glucose levels, monitoring HbA1c levels, and addressing the retinopathy through appropriate interventions. Regular eye examinations and timely treatment are crucial to prevent progression to more severe forms of retinopathy or vision loss.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Identification of drug or chemical causing diabetes
  • Assessment of retinopathy severity
  • Differentiation between types of diabetic retinopathy
  • Management of diabetes and its complications

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to document retinopathy severity
  • Lack of follow-up on eye examinations
  • Misclassification of diabetes type

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Thorough documentation of diabetes management, including medication history and HbA1c levels.

Common Clinical Scenarios

Patients presenting with new-onset diabetes due to medication, requiring insulin management.

Billing Considerations

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

Ophthalmology

Documentation Requirements

Detailed retinal examination findings, including grading of retinopathy and presence of macular edema.

Common Clinical Scenarios

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

Billing Considerations

Document all findings related to diabetic retinopathy and any treatments provided.

Coding Guidelines

Inclusion Criteria

Use E09.3319 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the drug or chemical causing diabetes
  • Include details on the severity of retinopathy and any associated complications
  • Ensure that the diagnosis is supported by clinical findings and laboratory results

Exclusion Criteria

Do NOT use E09.3319 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination, established patient

Clinical Scenario

Used during routine eye exams for diabetic patients.

Documentation Requirements

Document visual acuity, retinal findings, and any treatments provided.

Specialty Considerations

Ophthalmologists should ensure comprehensive documentation of diabetic retinopathy findings.

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 diabetes-related 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 diabetes-related 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 diabetes-related conditions.

Resources

Clinical References

  • •
    American Diabetes Association
  • •
    American Academy of Ophthalmology

Coding & Billing References

  • •
    American Diabetes Association
  • •
    American Academy of Ophthalmology

Frequently Asked Questions

What medications can induce diabetes mellitus?

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

How is diabetic retinopathy diagnosed?

Diabetic retinopathy is diagnosed through a comprehensive eye examination, including retinal imaging and assessment of visual acuity, along with the patient's diabetes history.