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ICD-10 Guide
ICD-10 CodesE09.3291

E09.3291

Billable

Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema (right eye)

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

Code Description

ICD-10 E09.3291 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema (right eye).

Key Diagnostic Point:

E09.3291 refers to diabetes mellitus that has been induced by drugs or chemicals, characterized by the presence of mild nonproliferative diabetic retinopathy in the right eye without associated macular edema. This condition arises when certain medications or toxic substances disrupt normal glucose metabolism, leading to hyperglycemia and subsequent diabetic complications. Nonproliferative diabetic retinopathy is an early stage of diabetic eye disease, where small blood vessels in the retina become damaged but do not yet lead to significant vision loss. The absence of macular edema indicates that there is no swelling in the macula, which is crucial for sharp central vision. Management of this condition typically involves controlling blood glucose levels through lifestyle modifications and pharmacotherapy, including insulin or oral hypoglycemic agents, while monitoring for potential ocular complications. Regular eye examinations are essential to detect any progression of retinopathy and to adjust treatment plans accordingly.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between drug-induced and other types of diabetes mellitus.
  • Understanding the specific type of retinopathy and its implications.
  • Accurate documentation of the absence of macular edema.
  • Knowledge of the medications that can induce diabetes.

Audit Risk Factors

  • Inadequate documentation of the drug or chemical causing diabetes.
  • Failure to document the specific type of retinopathy.
  • Misclassification of the severity of diabetic retinopathy.
  • Lack of follow-up documentation regarding the patient's eye health.

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, HbA1c levels, and management plans.

Common Clinical Scenarios

Patients presenting with new-onset diabetes due to medication, monitoring for complications.

Billing Considerations

Ensure clear documentation of the drug responsible for diabetes and its management.

Ophthalmology

Documentation Requirements

Comprehensive eye examination results, including retinal imaging.

Common Clinical Scenarios

Patients with diabetes presenting for routine eye exams or with visual complaints.

Billing Considerations

Document the absence of macular edema and the degree of retinopathy accurately.

Coding Guidelines

Inclusion Criteria

Use E09.3291 When
  • According to ICD
  • 10 guidelines, E09
  • 3291 should be used when diabetes is specifically induced by drugs or chemicals, and the documentation must clearly indicate the absence of macular edema and the presence of mild nonproliferative diabetic retinopathy
  • It is essential to ensure that the diagnosis aligns with clinical findings and treatment plans

Exclusion Criteria

Do NOT use E09.3291 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for diabetes management.

Documentation Requirements

Document the patient's diabetes management plan and any changes in medication.

Specialty Considerations

Endocrinologists should ensure comprehensive medication reviews.

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 data collection and reimbursement processes. This specificity aids in better tracking of diabetes cases related to medication use and associated complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of drug-induced diabetes, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of diabetes cases related to medication use and associated complications.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of diabetes cases related to medication use and associated 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 medications can induce diabetes mellitus?

Common medications that can induce diabetes include corticosteroids, certain antipsychotics, and some chemotherapy agents. It is important to review the patient's medication history to identify potential causes.

How is diabetic retinopathy diagnosed?

Diabetic retinopathy is diagnosed through a comprehensive eye examination, including fundoscopic examination and retinal imaging, to assess for changes in the retina.