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ICD-10 Guide
ICD-10 CodesE10.3299

E10.3299

Billable

Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema (unspecified eye)

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

Code Description

ICD-10 E10.3299 is a billable code used to indicate a diagnosis of type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema (unspecified eye).

Key Diagnostic Point:

E10.3299 refers to a specific condition in which a patient has Type 1 diabetes mellitus accompanied by mild nonproliferative diabetic retinopathy (NPDR) without macular edema in an unspecified eye. Type 1 diabetes is characterized by the autoimmune destruction of insulin-producing beta cells in the pancreas, leading to absolute insulin deficiency. Diabetic retinopathy is a common complication of diabetes, resulting from damage to the retinal blood vessels due to prolonged hyperglycemia. Mild NPDR is the earliest stage of diabetic retinopathy, where small areas of swelling in the retina occur, but there is no significant vision impairment or macular edema present. Management of this condition typically involves strict glycemic control, with an HbA1c target of less than 7% to prevent further progression of retinopathy. Insulin therapy is often required for Type 1 diabetes, and regular eye examinations are crucial for monitoring the progression of retinopathy. This code is essential for accurately documenting the presence of diabetic retinopathy in patients with Type 1 diabetes, which can influence treatment plans and patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of diabetic retinopathy
  • Understanding the nuances of diabetic complications
  • Accurate documentation of eye conditions
  • Management of diabetes and its complications

Audit Risk Factors

  • Inadequate documentation of retinopathy severity
  • Failure to document HbA1c levels
  • Lack of follow-up eye examination records
  • Misclassification of diabetic retinopathy stages

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed records of diabetes management, including insulin regimens and HbA1c levels.

Common Clinical Scenarios

Patients presenting with uncontrolled diabetes or complications related to diabetes.

Billing Considerations

Ensure comprehensive documentation of diabetes management and any associated complications.

Ophthalmology

Documentation Requirements

Thorough eye examination reports detailing the presence and severity of diabetic retinopathy.

Common Clinical Scenarios

Routine eye exams for diabetic patients and management of diabetic retinopathy.

Billing Considerations

Document the absence of macular edema and the specific findings related to NPDR.

Coding Guidelines

Inclusion Criteria

Use E10.3299 When
  • According to ICD
  • 10 guidelines, E10
  • 3299 should be used when a patient has Type 1 diabetes with mild NPDR without macular edema
  • It is essential to document the absence of macular edema clearly, as this differentiates it from other codes that include macular edema

Exclusion Criteria

Do NOT use E10.3299 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination, comprehensive, established patient

Clinical Scenario

Used during routine eye exams for diabetic patients.

Documentation Requirements

Document findings of the eye exam, including retinopathy assessment.

Specialty Considerations

Ophthalmologists should ensure detailed documentation of retinopathy stages.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of diabetic complications, improving the accuracy of patient records and treatment plans. E10.3299 provides a clear distinction between different stages of diabetic retinopathy, which is crucial for effective management.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of diabetic complications, improving the accuracy of patient records and treatment plans. E10.3299 provides a clear distinction between different stages of diabetic retinopathy, which is crucial for effective management.

Reimbursement & Billing Impact

The transition to ICD-10 allows for more specific coding of diabetic complications, improving the accuracy of patient records and treatment plans. E10.3299 provides a clear distinction between different stages of diabetic retinopathy, which is crucial for effective management.

Resources

Clinical References

  • •
    American Diabetes Association
  • •
    American Academy of Ophthalmology

Coding & Billing References

  • •
    American Diabetes Association
  • •
    American Academy of Ophthalmology

Frequently Asked Questions

What is the significance of coding E10.3299?

Coding E10.3299 accurately reflects the presence of mild nonproliferative diabetic retinopathy in patients with Type 1 diabetes, which is essential for appropriate management and treatment planning.

How often should patients with E10.3299 be monitored?

Patients should have regular eye examinations, typically annually, to monitor for progression of retinopathy and to ensure optimal diabetes management.