ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesE10.3291

E10.3291

Billable

Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema (right eye)

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

Code Description

ICD-10 E10.3291 is a billable code used to indicate a diagnosis of type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema (right eye).

Key Diagnostic Point:

E10.3291 refers to a specific condition in which a patient has Type 1 diabetes mellitus accompanied by mild nonproliferative diabetic retinopathy in the right eye, without the presence of macular edema. Type 1 diabetes is characterized by the autoimmune destruction of insulin-producing beta cells in the pancreas, leading to absolute insulin deficiency. Diabetic retinopathy is a common complication of diabetes, resulting from damage to the blood vessels in the retina due to prolonged hyperglycemia. Mild nonproliferative diabetic retinopathy is the earliest stage of the disease, where small areas of swelling (microaneurysms) occur in the retina, but there is no significant vision loss or macular edema. Management of this condition typically involves strict glycemic control, with an HbA1c target of less than 7% to minimize the risk of progression. Insulin therapy is often required to maintain blood glucose levels within the target range. Regular eye examinations are crucial for monitoring the progression of retinopathy and ensuring timely intervention if necessary.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the eye affected (right eye)
  • Differentiation between types of diabetic retinopathy
  • Requirement for detailed documentation of diabetes management
  • Need for accurate HbA1c level reporting

Audit Risk Factors

  • Inadequate documentation of retinopathy severity
  • Failure to report HbA1c levels accurately
  • Lack of clarity on the specific eye affected
  • Misclassification of diabetic retinopathy stages

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed records of diabetes management, including insulin regimens and HbA1c levels.

Common Clinical Scenarios

Patients presenting with uncontrolled diabetes or complications such as retinopathy.

Billing Considerations

Endocrinologists must ensure comprehensive documentation of diabetes management to support coding.

Ophthalmology

Documentation Requirements

Thorough eye examination reports detailing the presence and severity of diabetic retinopathy.

Common Clinical Scenarios

Routine eye exams for diabetic patients, especially those with known retinopathy.

Billing Considerations

Ophthalmologists should document the specific findings and any interventions performed.

Coding Guidelines

Inclusion Criteria

Use E10.3291 When
  • According to ICD
  • 10 coding guidelines, E10
  • 3291 should be used when documenting Type 1 diabetes with mild nonproliferative diabetic retinopathy without macular edema in the right eye
  • Coders must ensure that the documentation supports the diagnosis and that the specific eye affected is clearly indicated

Exclusion Criteria

Do NOT use E10.3291 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination, comprehensive, established patient

Clinical Scenario

Used during routine eye exams for diabetic patients.

Documentation Requirements

Documentation of the examination findings and any interventions.

Specialty Considerations

Ophthalmologists must ensure that the examination details support the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding diabetes-related complications, improving the accuracy of patient records and facilitating better management of diabetes and its complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding diabetes-related complications, improving the accuracy of patient records and facilitating better management of diabetes and its complications.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding diabetes-related complications, improving the accuracy of patient records and facilitating better management of diabetes and its complications.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What is the significance of specifying the eye affected in diabetic retinopathy coding?

Specifying the eye affected is crucial for accurate diagnosis and treatment planning, as it influences management strategies and potential interventions.