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ICD-10 Guide
ICD-10 CodesE10.39

E10.39

Billable

Type 1 diabetes mellitus with other diabetic ophthalmic complication

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

Code Description

ICD-10 E10.39 is a billable code used to indicate a diagnosis of type 1 diabetes mellitus with other diabetic ophthalmic complication.

Key Diagnostic Point:

Type 1 diabetes mellitus is characterized by the autoimmune destruction of insulin-producing beta cells in the pancreas, leading to absolute insulin deficiency. Patients with this condition are at risk for various complications, including diabetic ophthalmic complications such as diabetic retinopathy, cataracts, and other eye disorders. The term 'other diabetic ophthalmic complication' encompasses a range of conditions that may not be specifically classified under diabetic retinopathy but still result from chronic hyperglycemia. These complications can significantly impact visual acuity and quality of life. Management of Type 1 diabetes involves regular monitoring of blood glucose levels, maintaining HbA1c levels below 7% to minimize complications, and insulin therapy to achieve glycemic control. Regular eye examinations are crucial for early detection and management of ophthalmic complications, as timely intervention can prevent irreversible vision loss.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various diabetic ophthalmic complications
  • Understanding the nuances of Type 1 diabetes management
  • Interpreting HbA1c levels and their implications for treatment
  • Documenting the specific ophthalmic complications accurately

Audit Risk Factors

  • Inadequate documentation of ophthalmic complications
  • Failure to specify the type of diabetic complication
  • Incorrect linkage between diabetes and ophthalmic conditions
  • Lack of evidence for HbA1c levels in medical records

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 blood sugar levels and associated complications.

Billing Considerations

Ensure documentation reflects the type of diabetes and any complications to support coding.

Ophthalmology

Documentation Requirements

Comprehensive eye examination reports detailing findings related to diabetic complications.

Common Clinical Scenarios

Patients with visual disturbances or changes in vision due to diabetes.

Billing Considerations

Document specific findings related to diabetic ophthalmic complications to support accurate coding.

Coding Guidelines

Inclusion Criteria

Use E10.39 When
  • According to ICD
  • 10 coding guidelines, E10
  • 39 should be used when a patient with Type 1 diabetes presents with an ophthalmic complication that is not classified elsewhere
  • Coders must ensure that the documentation supports the diagnosis and that the complication is directly related to diabetes

Exclusion Criteria

Do NOT use E10.39 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination

Clinical Scenario

Used during routine eye exams for diabetic patients.

Documentation Requirements

Document findings related to diabetic complications.

Specialty Considerations

Ophthalmologists should ensure comprehensive documentation of diabetic eye disease.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of diabetic complications, improving the accuracy of claims and enhancing patient care through better tracking of diabetes-related conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetic complications, improving the accuracy of claims and enhancing patient care through better tracking of diabetes-related conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of diabetic complications, improving the accuracy of claims and enhancing patient care through better tracking of diabetes-related conditions.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What are the common ophthalmic complications associated with Type 1 diabetes?

Common complications include diabetic retinopathy, cataracts, and diabetic macular edema. Each of these conditions can significantly affect vision and require careful monitoring and management.