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ICD-10 Guide
ICD-10 CodesE09.3391

E09.3391

Billable

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

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

Code Description

ICD-10 E09.3391 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema (right eye).

Key Diagnostic Point:

E09.3391 refers to diabetes mellitus that is induced by drugs or chemicals, specifically characterized by moderate nonproliferative diabetic retinopathy in the right eye without macular edema. This condition arises when certain medications or substances disrupt normal glucose metabolism, leading to elevated blood glucose levels. The presence of moderate nonproliferative diabetic retinopathy indicates that there are changes in the retinal blood vessels, which may include microaneurysms and retinal hemorrhages, but without the presence of macular edema, which is a more severe complication. Management of this condition typically involves controlling blood glucose levels through lifestyle modifications, oral hypoglycemic agents, or insulin therapy, depending on the severity of the diabetes. Regular eye examinations are crucial to monitor the progression of retinopathy and to prevent further complications, such as vision loss.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between drug-induced and other types of diabetes
  • Identifying the specific drug or chemical responsible for diabetes
  • Understanding the nuances of diabetic retinopathy classifications
  • Documenting the absence of macular edema accurately

Audit Risk Factors

  • Inadequate documentation of drug history
  • Failure to specify the type of diabetic retinopathy
  • Lack of follow-up documentation for eye examinations
  • Misclassification of diabetes type

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, HbA1c levels, and treatment plans.

Common Clinical Scenarios

Patients presenting with elevated blood glucose levels after starting new medications.

Billing Considerations

Ensure clear documentation of the relationship between drug use and diabetes onset.

Ophthalmology

Documentation Requirements

Comprehensive eye exam results, including retinal imaging and assessment of retinopathy.

Common Clinical Scenarios

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

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use E09.3391 When
  • According to ICD
  • 10 guidelines, E09 codes are used for diabetes mellitus due to specific drugs or chemicals
  • It is essential to document the specific drug causing the condition and the presence of complications such as retinopathy

Exclusion Criteria

Do NOT use E09.3391 When
  • Exclusion criteria include diabetes not induced by drugs or chemicals

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for diabetes management.

Documentation Requirements

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

Specialty Considerations

Endocrinologists should ensure comprehensive documentation of diabetes control.

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 induce diabetes mellitus?

Common medications that can induce diabetes include corticosteroids, certain antipsychotics, and thiazide diuretics. It is important to document any recent medication changes in the patient's history.