ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesE10.3312

E10.3312

Billable

Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema (left eye)

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

Code Description

ICD-10 E10.3312 is a billable code used to indicate a diagnosis of type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema (left eye).

Key Diagnostic Point:

E10.3312 refers to a specific condition in which a patient has Type 1 diabetes mellitus accompanied by moderate nonproliferative diabetic retinopathy (NPDR) and macular edema in the left 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. Moderate NPDR indicates that there are noticeable changes in the retina, such as microaneurysms and retinal hemorrhages, but without the severe complications seen in proliferative diabetic retinopathy. Macular edema, a condition where fluid accumulates in the macula, can lead to vision impairment. This code emphasizes the importance of monitoring and managing diabetes to prevent complications, including regular eye examinations and maintaining optimal glycemic control, typically measured by HbA1c levels. Insulin management is crucial for Type 1 diabetes, and patients may require multiple daily injections or an insulin pump to achieve target blood glucose levels.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the condition (Type 1 diabetes with retinopathy and macular edema)
  • Need for accurate documentation of eye examination findings
  • Differentiation between types of diabetic retinopathy
  • Management of diabetes and associated complications

Audit Risk Factors

  • Inadequate documentation of eye examination results
  • Failure to specify the eye affected
  • Inconsistent HbA1c levels not correlating with diabetes management
  • Lack of follow-up documentation for diabetic retinopathy

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with uncontrolled diabetes or complications such as retinopathy.

Billing Considerations

Ensure comprehensive documentation of diabetes management and any referrals to ophthalmology.

Ophthalmology

Documentation Requirements

Thorough documentation of retinal examination findings, including the degree of retinopathy and presence of macular edema.

Common Clinical Scenarios

Patients with diabetes presenting for routine eye exams or vision changes.

Billing Considerations

Document the specific eye affected and the severity of findings to support coding.

Coding Guidelines

Inclusion Criteria

Use E10.3312 When
  • According to ICD
  • 10 guidelines, E10
  • 3312 should be used when the patient has Type 1 diabetes with moderate NPDR and macular edema in the left eye
  • Documentation must clearly indicate the type of diabetes, the presence of retinopathy, and the specific eye affected

Exclusion Criteria

Do NOT use E10.3312 When
  • Exclusion criteria include cases where the retinopathy is classified as severe or proliferative

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination, comprehensive, established patient

Clinical Scenario

Used during routine eye exams for diabetic retinopathy assessment.

Documentation Requirements

Document findings of the eye examination, including retinopathy severity.

Specialty Considerations

Ophthalmologists should ensure detailed documentation to support the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding diabetes-related complications, improving the accuracy of patient records and facilitating better management of diabetes and its complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding diabetes-related complications, improving the accuracy of patient records and facilitating better management of diabetes and its complications.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding diabetes-related complications, improving the accuracy of patient records and facilitating better management of diabetes and its complications.

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 E10.3312?

Coding E10.3312 accurately reflects the patient's condition, allowing for appropriate management and treatment of diabetes and its complications, particularly in the context of diabetic retinopathy.