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ICD-10 Guide
ICD-10 CodesE09.3599

E09.3599

Billable

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

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

Code Description

ICD-10 E09.3599 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema (unspecified eye).

Key Diagnostic Point:

E09.3599 refers to diabetes mellitus that has been induced by drugs or chemicals, leading to complications such as proliferative diabetic retinopathy without macular edema in an unspecified eye. This condition arises when certain medications or toxic substances disrupt normal glucose metabolism, resulting in hyperglycemia and subsequent diabetic complications. Proliferative diabetic retinopathy is characterized by the growth of new blood vessels in the retina, which can lead to vision loss if not managed properly. The absence of macular edema indicates that the central part of the retina is not swollen, which can be a more favorable prognosis. Management of this condition often involves controlling blood glucose levels through insulin therapy and monitoring HbA1c levels to assess long-term glucose control. Regular eye examinations are crucial to detect and manage retinal changes early, thereby preventing severe visual impairment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of drug-induced diabetes mechanisms
  • Differentiation from other types of diabetes
  • Specificity in documenting retinopathy stages
  • Need for accurate eye examination findings

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to specify the type of retinopathy
  • Lack of HbA1c level documentation
  • Inconsistent coding of diabetes type

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, HbA1c levels, and management plans.

Common Clinical Scenarios

Patients presenting with hyperglycemia due to medication, requiring insulin management.

Billing Considerations

Ensure clear documentation of the drug responsible for diabetes onset.

Ophthalmology

Documentation Requirements

Comprehensive eye examination findings, including retinal imaging results.

Common Clinical Scenarios

Patients with diabetic retinopathy requiring laser treatment or monitoring.

Billing Considerations

Document the absence of macular edema clearly to support coding.

Coding Guidelines

Inclusion Criteria

Use E09.3599 When
  • According to ICD
  • 10 guidelines, E09
  • 3599 should be used when diabetes is specifically induced by drugs or chemicals, and the presence of proliferative diabetic retinopathy is documented without macular edema
  • Coders must ensure that the documentation supports the diagnosis and that all relevant clinical details are included

Exclusion Criteria

Do NOT use E09.3599 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination

Clinical Scenario

Used for routine eye exams in patients with diabetic retinopathy.

Documentation Requirements

Document findings of the eye examination and any treatments provided.

Specialty Considerations

Ophthalmologists should ensure that the examination details are comprehensive.

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, 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 drug-induced diabetes, 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 drug-induced diabetes, 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.