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ICD-10 Guide
ICD-10 CodesE10.3532

E10.3532

Billable

Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula (left eye)

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

Code Description

ICD-10 E10.3532 is a billable code used to indicate a diagnosis of type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula (left eye).

Key Diagnostic Point:

E10.3532 refers to a specific condition in which a patient with Type 1 diabetes mellitus develops proliferative diabetic retinopathy (PDR), characterized by the growth of new blood vessels on the retina, leading to complications such as traction retinal detachment. In this case, the detachment does not involve the macula, which is crucial for central vision. PDR is a severe complication of diabetes that can lead to significant vision loss if not managed appropriately. The presence of traction retinal detachment indicates that the new blood vessels have caused the retina to pull away from its underlying supportive tissue. Management of this condition typically involves careful monitoring of blood glucose levels, maintaining HbA1c levels below 7% to reduce the risk of complications, and may require surgical intervention such as vitrectomy. Regular eye examinations are essential for early detection and treatment of diabetic retinopathy.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Specificity of the eye affected (left eye)
  • Presence of traction retinal detachment
  • Classification of diabetic retinopathy (proliferative)
  • Type 1 diabetes mellitus management considerations

Audit Risk Factors

  • Inadequate documentation of the retinal findings
  • Failure to specify the eye affected
  • Lack of evidence for the diagnosis of traction retinal detachment
  • Inconsistent HbA1c levels reported

Specialty Focus

Medical Specialties

Ophthalmology

Documentation Requirements

Detailed descriptions of retinal findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with vision changes, diabetic eye exams, and surgical interventions for retinal detachment.

Billing Considerations

Ensure clarity in documenting the type of retinal detachment and its implications for vision.

Endocrinology

Documentation Requirements

Comprehensive management plans for diabetes, including HbA1c levels and insulin therapy adjustments.

Common Clinical Scenarios

Routine diabetes management visits, complications assessment, and referrals to ophthalmology.

Billing Considerations

Document the patient's overall diabetes management and its impact on ocular health.

Coding Guidelines

Inclusion Criteria

Use E10.3532 When
  • According to ICD
  • 10 guidelines, this code should be used when the patient has a confirmed diagnosis of Type 1 diabetes with specific complications
  • Documentation must support the diagnosis of proliferative diabetic retinopathy and traction retinal detachment, specifying the eye involved

Exclusion Criteria

Do NOT use E10.3532 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

67228CPT Code

Laser photocoagulation

Clinical Scenario

Used for treating proliferative diabetic retinopathy.

Documentation Requirements

Document the extent of treatment and follow-up care.

Specialty Considerations

Ophthalmologists must document the rationale for laser treatment.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows 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 allows 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 allows 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 specifying the eye affected?

Specifying the eye affected is crucial for treatment planning and understanding the severity of the condition, as interventions may differ based on whether the right or left eye is involved.