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ICD-10 Guide
ICD-10 CodesE10.339

E10.339

Billable

Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema

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

Code Description

ICD-10 E10.339 is a billable code used to indicate a diagnosis of type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema.

Key Diagnostic Point:

E10.339 refers to a specific complication of Type 1 diabetes mellitus characterized by moderate nonproliferative diabetic retinopathy (NPDR) without macular edema. In this condition, patients experience changes in the retinal blood vessels due to prolonged hyperglycemia, leading to microaneurysms, retinal hemorrhages, and exudates. Moderate NPDR is defined by the presence of multiple microaneurysms and retinal hemorrhages, but without the severe complications associated with proliferative diabetic retinopathy, such as neovascularization or macular edema. The absence of macular edema indicates that the central vision is typically preserved, although patients may still experience visual disturbances. Management of this condition often involves strict glycemic control, regular ophthalmologic examinations, and potential interventions if the retinopathy progresses. The goal is to prevent further retinal damage and maintain visual acuity, emphasizing the importance of monitoring HbA1c levels to ensure they remain within target ranges.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation between types of diabetic retinopathy
  • Understanding of diabetes management and its complications
  • Need for precise documentation of retinopathy severity
  • Knowledge of associated conditions and their coding

Audit Risk Factors

  • Inadequate documentation of retinopathy severity
  • Failure to document HbA1c levels
  • Misclassification of diabetic retinopathy type
  • Lack of follow-up documentation for eye examinations

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed records of diabetes management, including HbA1c levels, treatment plans, and patient education.

Common Clinical Scenarios

Patients presenting with uncontrolled diabetes, requiring insulin adjustments and monitoring for complications.

Billing Considerations

Endocrinologists must ensure comprehensive documentation of diabetes management and any associated complications.

Ophthalmology

Documentation Requirements

Thorough retinal examination reports, including findings related to retinopathy severity and any interventions performed.

Common Clinical Scenarios

Routine eye exams for diabetic patients, assessment of retinopathy progression, and treatment planning.

Billing Considerations

Ophthalmologists should document the absence of macular edema clearly to support the coding of E10.339.

Coding Guidelines

Inclusion Criteria

Use E10.339 When
  • According to ICD
  • 10 coding guidelines, E10
  • 339 should be used when the patient has Type 1 diabetes with moderate NPDR and no macular edema
  • Coders must ensure that documentation supports the diagnosis and that the severity of retinopathy is clearly indicated

Exclusion Criteria

Do NOT use E10.339 When
  • Exclusions include cases where macular edema is present or where the retinopathy is classified as severe or proliferative

Related ICD-10 Codes

Related CPT Codes

92014CPT Code

Ophthalmological examination, comprehensive, established patient

Clinical Scenario

Used during routine eye exams for diabetic patients to assess retinopathy.

Documentation Requirements

Complete eye exam report detailing findings related to retinopathy.

Specialty Considerations

Ophthalmologists should ensure documentation supports the diagnosis 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 diabetic complications, improving the accuracy of diagnoses and treatment plans. E10.339 provides a clear distinction between different types of diabetic retinopathy, facilitating better management and tracking of patient outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetic complications, improving the accuracy of diagnoses and treatment plans. E10.339 provides a clear distinction between different types of diabetic retinopathy, facilitating better management and tracking of patient outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of diabetic complications, improving the accuracy of diagnoses and treatment plans. E10.339 provides a clear distinction between different types of diabetic retinopathy, facilitating better management and tracking of patient outcomes.

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 E10.339?

Coding E10.339 accurately reflects the patient's condition and helps in tracking the progression of diabetic retinopathy, which is crucial for effective management and treatment planning.

How often should patients with E10.339 be monitored?

Patients should have regular eye examinations, typically annually, or more frequently if retinopathy progresses or if HbA1c levels are not well controlled.