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ICD-10 Guide
ICD-10 CodesE09.3551

E09.3551

Billable

Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy (right eye)

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

Code Description

ICD-10 E09.3551 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy (right eye).

Key Diagnostic Point:

E09.3551 refers to diabetes mellitus that has been induced by drugs or chemicals, leading to complications such as proliferative diabetic retinopathy in the right eye. This condition arises when certain medications or substances disrupt normal glucose metabolism, resulting in hyperglycemia and subsequent diabetes. Proliferative diabetic retinopathy is characterized by the growth of new blood vessels in the retina, which can lead to vision impairment. The term 'stable' indicates that the retinopathy has not progressed or worsened, suggesting that the patient is under effective management. Management of this condition typically involves monitoring blood glucose levels, maintaining HbA1c levels below 7%, and possibly insulin therapy to control diabetes. Regular ophthalmologic evaluations are crucial to monitor the status of the retinopathy and prevent further complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of drug-induced diabetes mechanisms
  • Differentiation between types of diabetic retinopathy
  • Need for accurate documentation of eye involvement
  • Management of HbA1c levels and insulin therapy considerations

Audit Risk Factors

  • Inadequate documentation of drug or chemical exposure
  • Failure to document the stability of retinopathy
  • Misclassification of the type of diabetes
  • Inconsistent HbA1c levels reported

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, HbA1c levels, and management plans.

Common Clinical Scenarios

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

Billing Considerations

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

Ophthalmology

Documentation Requirements

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

Common Clinical Scenarios

Patients with diabetic retinopathy requiring laser treatment or monitoring.

Billing Considerations

Document the stability of retinopathy and any interventions performed.

Coding Guidelines

Inclusion Criteria

Use E09.3551 When
  • Follow ICD
  • CM guidelines for coding diabetes mellitus, ensuring to document the cause (drug or chemical) and the specific complications
  • Include details about the patient's management plan and any relevant lab results

Exclusion Criteria

Do NOT use E09.3551 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, medication adjustments, and HbA1c levels.

Specialty Considerations

Endocrinologists should ensure comprehensive diabetes management documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of diabetes types and complications, improving the accuracy of diabetes-related data and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetes types and complications, improving the accuracy of diabetes-related data and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of diabetes types and complications, improving the accuracy of diabetes-related data and facilitating better patient management.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What medications can induce diabetes mellitus?

Certain medications, including corticosteroids, antipsychotics, and some antihypertensives, can induce diabetes by affecting insulin secretion or action.