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ICD-10 Guide
ICD-10 CodesE09.3552

E09.3552

Billable

Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy (left eye)

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

Code Description

ICD-10 E09.3552 is a billable code used to indicate a diagnosis of drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy (left eye).

Key Diagnostic Point:

E09.3552 refers to diabetes mellitus that has been induced by drugs or chemicals, leading to complications such as proliferative diabetic retinopathy in the left eye. This condition arises when certain medications or toxic substances disrupt normal glucose metabolism, resulting in hyperglycemia and subsequent diabetes. Proliferative diabetic retinopathy is characterized by the growth of new blood vessels in the retina, which can lead to vision impairment. The term 'stable' indicates that the retinopathy has not progressed, and the patient may be under regular monitoring. Management of this condition often involves controlling blood glucose levels through insulin therapy or oral hypoglycemics, alongside regular ophthalmologic evaluations to monitor retinal health. The presence of diabetic retinopathy signifies a chronic complication of diabetes, necessitating a comprehensive approach to treatment and monitoring to prevent further ocular damage.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between drug-induced and other types of diabetes
  • Understanding the specific drug or chemical responsible for the diabetes
  • Accurate documentation of the severity and stability of retinopathy
  • Linking the diabetes diagnosis with the appropriate complications

Audit Risk Factors

  • Inadequate documentation of the drug or chemical causing diabetes
  • Failure to document the stability of the retinopathy
  • Incorrect coding of the eye affected by retinopathy
  • Lack of evidence for the diagnosis of diabetes mellitus

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed history of medication use, HbA1c levels, and management plans.

Common Clinical Scenarios

Patients presenting with new-onset diabetes after starting a specific medication.

Billing Considerations

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

Ophthalmology

Documentation Requirements

Comprehensive eye examination reports, including findings related to diabetic retinopathy.

Common Clinical Scenarios

Routine follow-ups for patients with diabetic retinopathy.

Billing Considerations

Document the stability of retinopathy and any changes in visual acuity.

Coding Guidelines

Inclusion Criteria

Use E09.3552 When
  • According to ICD
  • 10 guidelines, E09 codes are used for drug or chemical induced diabetes
  • It is essential to document the specific drug or chemical and the complications associated with diabetes
  • The stability of the diabetic retinopathy must also be noted to accurately apply this code

Exclusion Criteria

Do NOT use E09.3552 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 diabetic retinopathy.

Documentation Requirements

Complete eye examination report detailing findings.

Specialty Considerations

Ophthalmologists should document the stability of retinopathy.

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 patient records and facilitating better management of care.

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 patient records and facilitating better management of care.

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 patient records and facilitating better management of care.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of the 'stable' designation in E09.3552?

The 'stable' designation indicates that the proliferative diabetic retinopathy has not progressed, which is crucial for treatment planning and monitoring.