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ICD-10 Guide
ICD-10 CodesE09.3512

E09.3512

Billable

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

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

Code Description

ICD-10 E09.3512 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema (left eye).

Key Diagnostic Point:

E09.3512 refers to diabetes mellitus that has been induced by drugs or chemicals, leading to significant complications such as proliferative diabetic retinopathy and macular edema specifically in the left eye. Drug-induced diabetes can occur due to various medications, including corticosteroids, antipsychotics, and certain antiretrovirals, which can impair insulin secretion or action. Proliferative diabetic retinopathy is characterized by the growth of new blood vessels in the retina, which can lead to vision loss. Macular edema, a common complication, results from fluid accumulation in the macula, causing blurred vision. Management of this condition often involves controlling blood glucose levels, monitoring HbA1c levels, and potentially using insulin therapy or other antidiabetic medications. Regular eye examinations are crucial for early detection and treatment of retinopathy and edema.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of drug-induced diabetes mechanisms
  • Involves multiple complications that need to be documented
  • Specificity in eye-related complications must be noted
  • Differentiation from other types of diabetes is necessary

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to specify eye involvement
  • Incorrect coding of retinopathy severity
  • Lack of HbA1c level documentation

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, HbA1c levels, and treatment plans.

Common Clinical Scenarios

Management of drug-induced diabetes and monitoring for complications.

Billing Considerations

Ensure accurate documentation of the drug causing diabetes and its management.

Ophthalmology

Documentation Requirements

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

Common Clinical Scenarios

Evaluation and treatment of diabetic retinopathy and macular edema.

Billing Considerations

Document specific findings related to the left eye and treatment interventions.

Coding Guidelines

Inclusion Criteria

Use E09.3512 When
  • Follow ICD
  • CM guidelines for coding diabetes, ensuring to document the cause (drug or chemical) and the specific complications
  • Include HbA1c levels and treatment details where applicable

Exclusion Criteria

Do NOT use E09.3512 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination, comprehensive, established patient

Clinical Scenario

Used during follow-up visits for diabetic retinopathy management.

Documentation Requirements

Document visual acuity, retinal findings, and treatment plans.

Specialty Considerations

Ophthalmologists should ensure detailed documentation of eye health.

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 reimbursement processes.

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 reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 antiretrovirals are known to potentially induce diabetes by affecting insulin secretion or action.