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ICD-10 Guide
ICD-10 CodesE10.37

E10.37

Billable

Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment

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

Code Description

ICD-10 E10.37 is a billable code used to indicate a diagnosis of type 1 diabetes mellitus with diabetic macular edema, resolved following treatment.

Key Diagnostic Point:

E10.37 refers to a specific complication of Type 1 diabetes mellitus, characterized by the presence of diabetic macular edema (DME) that has resolved after appropriate treatment. Type 1 diabetes is an autoimmune condition where the pancreas produces little to no insulin, leading to elevated blood glucose levels. DME is a common complication of diabetes, resulting from the leakage of fluid from retinal blood vessels, causing swelling in the macula, which can impair vision. The resolution of DME indicates that the patient has responded positively to treatment, which may include laser therapy, anti-VEGF injections, or corticosteroids. Management of Type 1 diabetes involves regular monitoring of blood glucose levels and maintaining HbA1c levels below 7% to prevent complications. Insulin therapy is essential for these patients, and careful management is crucial to avoid both hyperglycemia and hypoglycemia. The coding of E10.37 requires thorough documentation of the patient's diabetes management, treatment of DME, and the resolution status of the edema.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires accurate documentation of diabetes type and complications.
  • Need for clear evidence of treatment and resolution of DME.
  • Differentiation from other diabetic eye diseases.
  • Management of HbA1c levels and insulin therapy must be documented.

Audit Risk Factors

  • Inadequate documentation of treatment effectiveness.
  • Failure to document HbA1c levels.
  • Lack of clarity on the resolution status of DME.
  • Misclassification of diabetes type.

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 DME.

Billing Considerations

Ensure that all treatment plans and patient responses are documented clearly.

Ophthalmology

Documentation Requirements

Comprehensive eye examination reports, treatment plans for DME, and follow-up notes.

Common Clinical Scenarios

Patients with vision changes due to DME requiring intervention.

Billing Considerations

Document the specific treatments used and their outcomes to support coding.

Coding Guidelines

Inclusion Criteria

Use E10.37 When
  • According to ICD
  • 10 guidelines, E10
  • 37 should be used when there is a confirmed diagnosis of Type 1 diabetes with a history of DME that has resolved
  • Documentation must support the resolution status and treatment provided

Exclusion Criteria

Do NOT use E10.37 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

67228CPT Code

Laser photocoagulation for diabetic retinopathy

Clinical Scenario

Used when treating DME in patients with Type 1 diabetes.

Documentation Requirements

Document the indication for treatment and the patient's response.

Specialty Considerations

Ophthalmologists should ensure that the procedure is linked to the diagnosis of DME.

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 diabetes 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 facilitating better management of diabetes and its complications.

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 diabetes and its complications.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What is the significance of documenting the resolution of DME?

Documenting the resolution of DME is crucial for accurate coding and billing, as it indicates the effectiveness of treatment and helps in tracking the patient's progress.