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ICD-10 Guide
ICD-10 CodesE10.3293

E10.3293

Billable

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

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

Code Description

ICD-10 E10.3293 is a billable code used to indicate a diagnosis of type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema (bilateral).

Key Diagnostic Point:

E10.3293 refers to a specific condition in which a patient has Type 1 diabetes mellitus accompanied by mild nonproliferative diabetic retinopathy affecting both eyes, but 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 retinal blood vessels due to prolonged hyperglycemia. Mild nonproliferative diabetic retinopathy indicates early changes in the retina, such as microaneurysms and retinal hemorrhages, but without the more severe complications associated with proliferative diabetic retinopathy or macular edema. Management of this condition typically involves strict glycemic control, regular ophthalmologic examinations, and potential insulin therapy adjustments to maintain optimal HbA1c levels, ideally below 7% to prevent further retinal damage.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation between types of diabetic retinopathy
  • Need for accurate documentation of diabetes type and complications
  • Understanding of bilateral vs unilateral conditions
  • Management of HbA1c levels and insulin therapy

Audit Risk Factors

  • Inadequate documentation of retinopathy severity
  • Failure to specify bilateral involvement
  • Misclassification of diabetes type
  • Inconsistent HbA1c reporting

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

Ensure clear documentation of diabetes type and any associated complications.

Ophthalmology

Documentation Requirements

Comprehensive eye examination reports detailing findings of diabetic retinopathy.

Common Clinical Scenarios

Routine diabetic eye exams and management of retinopathy.

Billing Considerations

Document the absence of macular edema and specify bilateral involvement.

Coding Guidelines

Inclusion Criteria

Use E10.3293 When
  • According to ICD
  • 10 guidelines, E10
  • 3293 should be used when documenting Type 1 diabetes with mild nonproliferative diabetic retinopathy without macular edema
  • Coders must ensure that the documentation supports the diagnosis and that the absence of macular edema is clearly stated

Exclusion Criteria

Do NOT use E10.3293 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 retinopathy assessment.

Documentation Requirements

Detailed findings of the eye examination, including retinopathy status.

Specialty Considerations

Ophthalmologists must document the severity and type 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 diabetes-related complications, improving the accuracy of patient records and facilitating better management of diabetic conditions.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

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

Resources

Clinical References

  • •
    American Diabetes Association
  • •
    American Academy of Ophthalmology

Coding & Billing References

  • •
    American Diabetes Association
  • •
    American Academy of Ophthalmology

Frequently Asked Questions

What is the significance of coding E10.3293?

Coding E10.3293 accurately reflects the patient's condition, allowing for appropriate management and treatment of Type 1 diabetes and its complications, particularly diabetic retinopathy.