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ICD-10 Guide
ICD-10 CodesE10.3392

E10.3392

Billable

Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema (left eye)

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

Code Description

ICD-10 E10.3392 is a billable code used to indicate a diagnosis of type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema (left eye).

Key Diagnostic Point:

E10.3392 refers to a specific condition in which a patient has Type 1 diabetes mellitus accompanied by moderate nonproliferative diabetic retinopathy affecting the left 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 retinal blood vessels due to chronic hyperglycemia. Moderate nonproliferative diabetic retinopathy is identified by the presence of microaneurysms, retinal hemorrhages, and exudates, but without the more severe complications associated with proliferative diabetic retinopathy or macular edema. Management of this condition typically involves strict glycemic control, often monitored through HbA1c levels, which should ideally be maintained below 7% to prevent further retinal damage. Insulin therapy is essential for Type 1 diabetes management, and regular ophthalmologic evaluations are crucial for monitoring the progression of retinopathy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the eye affected (left eye)
  • Differentiation between nonproliferative and proliferative retinopathy
  • Exclusion of macular edema
  • Need for precise documentation of diabetes management and retinopathy severity

Audit Risk Factors

  • Inadequate documentation of retinopathy severity
  • Failure to specify the eye affected
  • Incorrect coding of diabetes type
  • Lack of HbA1c level documentation

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with uncontrolled diabetes, requiring insulin adjustments.

Billing Considerations

Ensure documentation reflects the type of diabetes and any complications.

Ophthalmology

Documentation Requirements

Comprehensive eye examination reports detailing retinopathy findings.

Common Clinical Scenarios

Routine diabetic eye exams for patients with known diabetes.

Billing Considerations

Document the presence or absence of macular edema and specify the eye affected.

Coding Guidelines

Inclusion Criteria

Use E10.3392 When
  • According to ICD
  • 10 guidelines, E10
  • 3392 should be used when documenting Type 1 diabetes with specified complications
  • It is essential to include the severity of retinopathy and the absence of macular edema in the documentation
  • The code should not be used if the patient has proliferative diabetic retinopathy or macular edema

Exclusion Criteria

Do NOT use E10.3392 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

Document findings of retinopathy and any changes in vision.

Specialty Considerations

Ophthalmologists should ensure detailed documentation of 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 diabetic complications, improving the accuracy of patient records and facilitating better management of diabetes-related conditions.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

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

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What is the significance of specifying the eye affected?

Specifying the eye affected is crucial for treatment planning and monitoring progression, as diabetic retinopathy can differ significantly between eyes.