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ICD-10 Guide
ICD-10 CodesE09.3499

E09.3499

Billable

Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema (unspecified eye)

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

Code Description

ICD-10 E09.3499 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema (unspecified eye).

Key Diagnostic Point:

E09.3499 refers to diabetes mellitus that is induced by drugs or chemicals, characterized by severe nonproliferative diabetic retinopathy without macular edema in an unspecified eye. This condition arises when certain medications or substances disrupt normal glucose metabolism, leading to elevated blood glucose levels. The severe nonproliferative diabetic retinopathy indicates significant retinal damage, which can lead to vision impairment if not managed properly. Patients may present with symptoms such as blurred vision, floaters, or difficulty seeing at night. Management typically involves controlling blood glucose levels through lifestyle modifications, oral hypoglycemic agents, or insulin therapy. Regular ophthalmologic evaluations are crucial to monitor retinal health and prevent progression to proliferative diabetic retinopathy or other complications. The absence of macular edema distinguishes this condition from other forms of diabetic retinopathy, which may require different management strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between drug-induced and other types of diabetes mellitus
  • Identifying the severity of retinopathy and its implications for treatment
  • Understanding the specific medications that can induce diabetes
  • Documenting the absence of macular edema accurately

Audit Risk Factors

  • Inadequate documentation of drug history leading to diabetes
  • Failure to specify the severity of retinopathy
  • Misclassification of diabetic retinopathy type
  • Lack of follow-up documentation for eye examinations

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 inducing diabetes.

Ophthalmology

Documentation Requirements

Comprehensive eye exam results, including retinal imaging and assessment of retinopathy severity.

Common Clinical Scenarios

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

Billing Considerations

Document the absence of macular edema and any changes in retinopathy status.

Coding Guidelines

Inclusion Criteria

Use E09.3499 When
  • According to ICD
  • 10 guidelines, E09
  • 3499 should be used when diabetes is specifically induced by drugs or chemicals, and the documentation must clearly indicate the absence of macular edema
  • It is important to include the severity of retinopathy in the clinical documentation

Exclusion Criteria

Do NOT use E09.3499 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination, comprehensive, established patient

Clinical Scenario

Used for routine eye exams in diabetic patients.

Documentation Requirements

Document visual acuity, fundoscopic findings, and retinopathy assessment.

Specialty Considerations

Ophthalmologists should ensure thorough documentation of retinopathy severity.

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 strategies.

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 strategies.

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 strategies.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What medications can induce diabetes mellitus?

Common medications that can induce diabetes include corticosteroids, certain antipsychotics, and some antihypertensive agents. It is crucial to document the specific medication responsible for the condition.