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ICD-10 Guide
ICD-10 CodesE09.3312

E09.3312

Billable

Drug or chemical induced 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 E09.3312 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema (left eye).

Key Diagnostic Point:

E09.3312 refers to diabetes mellitus that is induced by drugs or chemicals, characterized by the presence of moderate nonproliferative diabetic retinopathy with macular edema specifically affecting the left eye. This condition arises when certain medications or substances disrupt normal glucose metabolism, leading to hyperglycemia and subsequent diabetic complications. Nonproliferative diabetic retinopathy is an early stage of diabetic eye disease where the retina shows signs of damage but has not yet progressed to the more severe proliferative stage. Macular edema, a common complication, occurs when fluid accumulates in the macula, leading to vision impairment. Management of this condition typically involves controlling blood glucose levels, monitoring HbA1c levels, and addressing the ocular complications through appropriate interventions. Regular ophthalmologic evaluations are crucial for early detection and treatment of retinopathy to prevent vision loss.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of drug-induced diabetes mechanisms
  • Involves specific eye-related complications
  • Need for precise documentation of retinopathy severity
  • Differentiation from other types of diabetes

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to specify the eye affected
  • Misclassification of retinopathy severity
  • Lack of HbA1c level documentation

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 accurate documentation of drug history and diabetes management strategies.

Ophthalmology

Documentation Requirements

Detailed retinal examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients with diabetic retinopathy requiring laser treatment or injections.

Billing Considerations

Document the specific eye affected and the severity of retinopathy.

Coding Guidelines

Inclusion Criteria

Use E09.3312 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the drug or chemical causing diabetes, the severity of retinopathy, and the specific eye affected
  • Include HbA1c levels to support the diagnosis

Exclusion Criteria

Do NOT use E09.3312 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination, established patient

Clinical Scenario

Used for routine follow-up of diabetic retinopathy.

Documentation Requirements

Document visual acuity, retinal findings, and treatment plan.

Specialty Considerations

Ophthalmologists should ensure detailed documentation of retinal examination.

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 and its complications, improving data accuracy and patient care tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of drug-induced diabetes and its complications, improving data accuracy and patient care tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of drug-induced diabetes and its complications, improving data accuracy and patient care tracking.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What medications can induce diabetes mellitus?

Common medications that can induce diabetes include corticosteroids, certain antipsychotics, and some antihypertensive drugs. It's essential to document any relevant medication history when coding.