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 CodesE10.3522

E10.3522

Billable

Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula (left eye)

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

Code Description

ICD-10 E10.3522 is a billable code used to indicate a diagnosis of type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula (left eye).

Key Diagnostic Point:

E10.3522 refers to a specific complication of Type 1 diabetes mellitus characterized by proliferative diabetic retinopathy (PDR) that has progressed to include traction retinal detachment affecting the macula in the left eye. PDR is a severe form of diabetic retinopathy where new, abnormal blood vessels grow on the retina, which can lead to vision loss. The presence of traction retinal detachment indicates that these abnormal vessels have pulled on the retina, causing it to detach from the underlying tissue. This condition is often associated with poorly controlled blood glucose levels over time, leading to elevated HbA1c levels. Management typically involves insulin therapy to control blood glucose levels, alongside potential surgical interventions such as vitrectomy to address the retinal detachment. Regular eye examinations are crucial for early detection and management of diabetic eye complications.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Specificity of the condition (Type 1 diabetes with PDR and retinal detachment)
  • Need for precise documentation of eye involvement (left eye, macula)
  • Differentiation from other types of diabetic retinopathy
  • Potential for multiple complications requiring detailed coding

Audit Risk Factors

  • Inadequate documentation of the type of diabetic retinopathy
  • Failure to specify eye involvement
  • Misclassification of diabetes type (Type 1 vs. Type 2)
  • Lack of evidence for HbA1c levels and insulin management

Specialty Focus

Medical Specialties

Ophthalmology

Documentation Requirements

Detailed eye examination findings, including visual acuity and retinal imaging results.

Common Clinical Scenarios

Patients presenting with vision changes, floaters, or signs of retinal detachment.

Billing Considerations

Ensure clear documentation of the extent of retinal detachment and any surgical interventions performed.

Endocrinology

Documentation Requirements

Comprehensive diabetes management records, including HbA1c levels and insulin regimen.

Common Clinical Scenarios

Patients with poorly controlled diabetes presenting with complications.

Billing Considerations

Document the patient's diabetes management plan and any referrals to ophthalmology.

Coding Guidelines

Inclusion Criteria

Use E10.3522 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the type of diabetes, specific complications, and eye involvement
  • Include any relevant lab results, such as HbA1c levels, to support the diagnosis

Exclusion Criteria

Do NOT use E10.3522 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

67228CPT Code

Laser photocoagulation

Clinical Scenario

Used for treatment of PDR in patients with traction retinal detachment.

Documentation Requirements

Document the extent of laser treatment and patient response.

Specialty Considerations

Ophthalmology should provide detailed operative notes.

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 reimbursement processes. E10.3522 provides a clear distinction of the severity of diabetic retinopathy and its complications.

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 reimbursement processes. E10.3522 provides a clear distinction of the severity of diabetic retinopathy and its complications.

Reimbursement & Billing Impact

reimbursement processes. E10.3522 provides a clear distinction of the severity of diabetic retinopathy and its complications.

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 specifying the left eye in E10.3522?

Specifying the left eye is crucial for treatment planning and documentation, as it indicates the specific eye affected by the complications of diabetic retinopathy, which can influence management strategies.