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ICD-10 Guide
ICD-10 CodesE09.3313

E09.3313

Billable

Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema (bilateral)

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

Code Description

ICD-10 E09.3313 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema (bilateral).

Key Diagnostic Point:

E09.3313 refers to diabetes mellitus that is induced by drugs or chemicals, characterized by moderate nonproliferative diabetic retinopathy with bilateral macular edema. This condition arises when certain medications or substances lead to insulin resistance or impaired insulin secretion, resulting in elevated blood glucose levels. The presence of moderate nonproliferative diabetic retinopathy indicates damage to the retinal blood vessels, which can lead to vision complications. Macular edema, a common complication, occurs when fluid accumulates in the macula, affecting central vision. Management of this condition often involves controlling blood glucose levels through lifestyle modifications, oral hypoglycemic agents, or insulin therapy, while also addressing the ocular complications through regular eye examinations and potential interventions such as laser therapy or injections. Monitoring HbA1c levels is crucial to assess long-term glycemic control and adjust treatment plans accordingly.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of drug-induced diabetes mechanisms
  • Involves knowledge of diabetic retinopathy stages
  • Need for accurate documentation of ocular findings
  • Complexity in differentiating from other diabetes types

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to document severity of retinopathy
  • Lack of clarity in distinguishing between types of diabetes
  • Insufficient follow-up documentation for ocular conditions

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, HbA1c levels, and treatment plans.

Common Clinical Scenarios

Patients presenting with new-onset diabetes due to medication, management of diabetes with concurrent ocular complications.

Billing Considerations

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

Ophthalmology

Documentation Requirements

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

Common Clinical Scenarios

Patients with diabetes presenting for routine eye exams, management of diabetic retinopathy.

Billing Considerations

Document the severity of retinopathy and any interventions performed.

Coding Guidelines

Inclusion Criteria

Use E09.3313 When
  • According to ICD
  • 10 guidelines, E09
  • 3313 should be used when diabetes is specifically induced by drugs or chemicals, and when there is documented moderate nonproliferative diabetic retinopathy with bilateral macular edema
  • Coders must ensure that all components of the diagnosis are documented clearly

Exclusion Criteria

Do NOT use E09.3313 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination, comprehensive, established patient

Clinical Scenario

Used for routine eye exams in patients with diabetes.

Documentation Requirements

Document visual acuity, retinal findings, and any interventions.

Specialty Considerations

Ophthalmologists should ensure thorough documentation of diabetic retinopathy findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

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

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

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

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What medications can cause drug-induced diabetes?

Medications such as corticosteroids, certain antipsychotics, and some chemotherapy agents are known to induce diabetes by affecting insulin sensitivity or secretion.