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ICD-10 Guide
ICD-10 CodesE09.3419

E09.3419

Billable

Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema (unspecified eye)

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

Code Description

ICD-10 E09.3419 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema (unspecified eye).

Key Diagnostic Point:

E09.3419 refers to diabetes mellitus that is induced by drugs or chemicals, characterized by severe nonproliferative diabetic retinopathy with associated macular edema in an unspecified eye. This condition arises when certain medications, such as corticosteroids or antipsychotics, lead to insulin resistance or impaired insulin secretion, resulting in hyperglycemia. The severe nonproliferative diabetic retinopathy indicates significant retinal damage, where the blood vessels in the retina are affected, leading to potential vision loss. Macular edema, a complication of diabetic retinopathy, occurs when fluid accumulates in the macula, the central part of the retina responsible for sharp vision. Management of this condition often involves controlling blood glucose levels, monitoring HbA1c levels, and addressing the ocular complications through appropriate interventions. Regular eye examinations and timely treatment are crucial to prevent further deterioration of vision.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of drug-induced diabetes mechanisms
  • Involves multiple complications (retinopathy and macular edema)
  • Need for precise documentation of eye conditions
  • Differentiation from other types of diabetes and retinopathy

Audit Risk Factors

  • Inadequate documentation of drug or chemical causation
  • Failure to specify the eye affected
  • Lack of detailed clinical notes on retinopathy severity
  • Inconsistent HbA1c level documentation

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed medication history, HbA1c levels, and diabetes management plans.

Common Clinical Scenarios

Patients presenting with new-onset diabetes after starting corticosteroids.

Billing Considerations

Ensure clear documentation of the relationship between medication and diabetes onset.

Ophthalmology

Documentation Requirements

Comprehensive eye examination reports, including retinal imaging and visual acuity assessments.

Common Clinical Scenarios

Patients with diabetes presenting with vision changes or retinal findings.

Billing Considerations

Document the severity of retinopathy and any treatments administered.

Coding Guidelines

Inclusion Criteria

Use E09.3419 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the cause of diabetes, the severity of retinopathy, and the presence of macular edema
  • Include all relevant clinical findings and treatment plans

Exclusion Criteria

Do NOT use E09.3419 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 diabetic patients.

Documentation Requirements

Document visual acuity, retinal findings, and any treatments provided.

Specialty Considerations

Ophthalmologists should ensure thorough documentation of diabetic retinopathy severity.

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 the accuracy of claims and facilitating better patient management.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of drug-induced diabetes and its complications, improving the accuracy of 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?

Medications such as corticosteroids, certain antipsychotics, and some antihypertensives can induce diabetes by affecting insulin sensitivity or secretion.