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ICD-10 Guide
ICD-10 CodesE09.352

E09.352

Billable

Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula

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

Code Description

ICD-10 E09.352 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula.

Key Diagnostic Point:

E09.352 refers to diabetes mellitus that is induced by drugs or chemicals, characterized by the presence of proliferative diabetic retinopathy (PDR) and traction retinal detachment affecting the macula. Drug-induced diabetes can arise from various medications, including corticosteroids, antipsychotics, and certain chemotherapeutic agents. Proliferative diabetic retinopathy is a severe complication of diabetes, marked by the growth of new blood vessels in the retina, which can lead to vision loss. The traction retinal detachment occurs when these new vessels pull on the retina, causing it to detach from the underlying tissue, particularly affecting the macula, which is crucial for central vision. Management of this condition requires a multidisciplinary approach, including endocrinology for diabetes management and ophthalmology for retinal issues. Regular monitoring of HbA1c levels is essential to assess long-term glucose control, with targets typically set below 7% for most adults. Insulin therapy may be necessary to achieve glycemic control, especially in cases where oral hypoglycemics are ineffective due to the severity of the condition.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of drug-induced diabetes mechanisms
  • Involves multiple complications (PDR and retinal detachment)
  • Need for precise documentation of retinopathy severity
  • Potential for overlapping codes with other diabetic conditions

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to document the severity of retinopathy
  • Misclassification of diabetes type
  • Lack of clear linkage between diabetes and retinal complications

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, HbA1c levels, and diabetes management plan.

Common Clinical Scenarios

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

Billing Considerations

Ensure clear documentation of the specific drug causing diabetes and its management.

Ophthalmology

Documentation Requirements

Detailed retinal examination findings, including the extent of retinopathy and presence of traction detachment.

Common Clinical Scenarios

Patients with diabetes presenting with vision changes due to retinal complications.

Billing Considerations

Document the visual acuity and specific retinal findings to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use E09.352 When
  • According to ICD
  • 10 guidelines, E09
  • 352 should be used when diabetes is specifically induced by drugs or chemicals, and there is evidence of proliferative diabetic retinopathy with traction retinal detachment
  • Documentation must clearly indicate the cause of diabetes and the complications present
  • induced or where retinopathy is not proliferative

Exclusion Criteria

Do NOT use E09.352 When
  • Exclusion criteria include cases where diabetes is not drug

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination, comprehensive, established patient

Clinical Scenario

Used during follow-up visits for diabetic retinopathy assessment.

Documentation Requirements

Document visual acuity, retinal findings, and treatment plan.

Specialty Considerations

Ophthalmologists should ensure thorough documentation of retinal examination.

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 data collection and reimbursement processes. E09.352 provides a clear framework for documenting complex cases involving diabetes and retinal complications.

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 data collection and reimbursement processes. E09.352 provides a clear framework for documenting complex cases involving diabetes and retinal complications.

Reimbursement & Billing Impact

reimbursement processes. E09.352 provides a clear framework for documenting complex cases involving diabetes and retinal complications.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What medications can induce diabetes mellitus?

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