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ICD-10 Guide
ICD-10 CodesE10.36

E10.36

Billable

Type 1 diabetes mellitus with diabetic cataract

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

Code Description

ICD-10 E10.36 is a billable code used to indicate a diagnosis of type 1 diabetes mellitus with diabetic cataract.

Key Diagnostic Point:

Type 1 diabetes mellitus is a chronic condition characterized by the body's inability to produce insulin due to autoimmune destruction of pancreatic beta cells. Diabetic cataract is a common complication of diabetes, resulting from prolonged hyperglycemia leading to changes in the lens of the eye. Patients with type 1 diabetes often experience fluctuations in blood glucose levels, which can exacerbate the risk of developing cataracts. The presence of diabetic cataract can significantly impair vision and quality of life, necessitating careful management of blood glucose levels and regular ophthalmologic evaluations. The management of type 1 diabetes typically involves insulin therapy, with the goal of maintaining HbA1c levels below 7% to minimize complications. However, even with optimal control, patients may still develop diabetic cataracts, highlighting the importance of routine eye examinations and patient education on the signs and symptoms of vision changes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of diabetes management and complications
  • Need for accurate documentation of both diabetes and cataract
  • Potential for multiple related codes depending on complications
  • Differentiation from other types of diabetes-related eye conditions

Audit Risk Factors

  • Inadequate documentation of diabetic complications
  • Failure to document HbA1c levels
  • Misclassification of type of diabetes
  • Lack of ophthalmology referral notes

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 and related complications.

Billing Considerations

Ensure documentation reflects the complexity of managing diabetes with complications.

Ophthalmology

Documentation Requirements

Comprehensive eye examination reports, including findings related to cataracts.

Common Clinical Scenarios

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

Billing Considerations

Document the relationship between diabetes control and cataract development.

Coding Guidelines

Inclusion Criteria

Use E10.36 When
  • According to ICD
  • 10 guidelines, E10
  • 36 should be used when a patient with type 1 diabetes has been diagnosed with diabetic cataract
  • Coders must ensure that the documentation supports the diagnosis and that the cataract is directly related to the diabetes

Exclusion Criteria

Do NOT use E10.36 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

66984CPT Code

Extracapsular cataract removal with insertion of intraocular lens

Clinical Scenario

Used when a patient with E10.36 undergoes cataract surgery.

Documentation Requirements

Surgical notes and pre-operative assessments must document the diabetes diagnosis.

Specialty Considerations

Ophthalmologists should ensure diabetes management is optimized pre-surgery.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

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

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What is the significance of coding E10.36?

Coding E10.36 accurately reflects the patient's condition, ensuring appropriate management and treatment for both diabetes and its complications, which is crucial for quality care and reimbursement.