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Moderate Nonproliferative Diabetic Retinopathy With Macular Edema Icd 10

Icd 10 Code For Type 1 Diabetes Mellitus With Moderate Nonproliferative Diabetic Retinopathy With Macular Edema E10.331

Icd 10 Code For Type 1 Diabetes Mellitus With Moderate Nonproliferative Diabetic Retinopathy With Macular Edema E10.331

Questions related to E10.331 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema The word 'Includes' appears immediately under certain categories to further define, or give examples of, the content of thecategory. A type 1 Excludes note is a pure excludes. It means 'NOT CODED HERE!' An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. A type 2 Excludes note represents 'Not included here'. An Excludes2 note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When an Excludes2 note appears under a code it is acceptable to use both the code and the excluded code together. A code also note instructs that 2 codes may be required to fully describe a condition but the sequencing of the two codes is discretionary, depending on the severity of the conditions and the reason for the encounter. Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a 'use additional code' note at the etiology code, and a 'code first' note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, 'in diseases classified elsewhere.' Codes with this title are Continue reading >>

Dm With Diabetic Arthropathy E10.61- E11.61-

Dm With Diabetic Arthropathy E10.61- E11.61-

DM w/OTHER SPECIFIED COMPLICATIONS DM II (E11) w/diab. Neuropathic arthropathy E10.610 E11.610 with other diab. Arthropathy E10.618 E11.618 DM with skin complications E10.62- E11.62- DM with diabetic Dermatitis E10.620 E11.620 E10.621 E11.621 E10.622 E11.622 DM with other skin complication E10.628 E11.628 DM with oral complications E10.63- E11.63- DM with periodontal disease E10.630 E11.630 DM with other oral complications E10.638 E11.638 DM with hypoglycemia E10.64- E11.64- with coma E10.641 E11.641 without coma E10.649 E11.649 DM with hyperglycemia E10.65 E11.65 E10.69 E11.69 DM with unspecified complications E10.8 E11.8 DM without complications E10.9 E11.9 Z79.4Insulin Use DM I (E10) DM with foot ulcer And site L97.4-,L97.5- DM with other skin ulcer And site L97.1- L97.9,L98.41-L98.49 DM with other specified complication And code for complication (Ex: Male erectile dysfunction, unsp.(N52.9) Code Diabetes Mellitus due to an underlying condition Code first the underlying condition E08 Drug or chemical induced DM Code first poisoning due to drug or toxin, if applicable (T36-T65 with 5th or 6th character 1-4 or 6) E09 E13 OTHER Other specified diabetes mellitus DM II (E11) DM w/diabetic neuropathy, unsp E10.40 E11.40 DM w/diabetic mononeuropathy E10.41 E11.41 DM w/diabetic polyneuropathy w/diabetic neuralgia E10.42 E11.42 DM w/diabetic autonomic (poly)neuropathy w/diabetic gastroparesis E10.43 E11.43 DM w/diabetic amyotrophy E10.44 E11.44 DM w/other diabetic neurological complication E10.49 E11.49 DM I (E10)NEUROLOGICAL DM w/neurological complications DM II (E11) DM w/diabetic periph.angiopathy without gangrene E10.51 E11.51 DM w/diabetic periph.angiopathy with gangrene E10.52 E11.52 DM w/other circulatory complication E10.59 E11.59 DM I (E10)CIRCULATORY DM w/circulatory Continue reading >>

Coding Q&a

Coding Q&a

CODING Q&A Diabetes Coding for ICD-10-CM SUZANNE L. CORCORAN, COE Coding and documentation for diabetes and especially diabetic eye disease have changed substantially with the implementation of ICD-10. Here are some considerations to keep in mind. Q. What are the major differences between ICD-9 and ICD-10 for diabetes? A. In coding diabetic eye disease, there are many changes. Instead of coding diabetes plus any ocular manifestations as separate codes, ICD-10 has introduced “combination codes” that describe the type of diabetes as well as any retinopathy and edema. In ICD-9, we coded diabetes as follows, with a fifth digit to identify the type of diabetes. 250.0_ Diabetes mellitus w/o mention of complication or manifestation 250.5_ Diabetes mellitus with ophthalmic manifestations • 0 – Type II, or unspecified type, not stated as uncontrolled • 1 – Type I [juvenile], not stated as uncontrolled • 2 – Type II, or unspecified type, uncontrolled • 3 – Type I [juvenile], uncontrolled When there was diabetic retinopathy, we coded also: 362.0 – Diabetic retinopathy • 362.01 – Background diabetic retinopathy • 362.02 – Proliferative diabetic retinopathy (PDR) • 362.03 – Nonproliferative diabetic retinopathy, NOS (NPDR) • 362.04 – Mild nonproliferative diabetic retinopathy (NPDR) • 362.05 – Moderate nonproliferative diabetic retinopathy (NPDR) • 362.06 – Severe nonproliferative diabetic retinopathy (NPDR) • 362.07 – Diabetic macular edema (DME) Suzanne L. Corcoran, COE, is executive vice president and founder of Corcoran Consulting Group, San Bernardino, CA, which specializes in coding and reimbursement issues for ophthalmic practices. Her e-mail is [email protected] In ICD-10, everything has changed. First, the concept o Continue reading >>

Type 2 Diabetes Mellitus With Moderate Nonproliferative Diabetic Retinopathy With Macular Edema

Type 2 Diabetes Mellitus With Moderate Nonproliferative Diabetic Retinopathy With Macular Edema

Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema - E11.331 See: Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy Back to E11.33 ICD-10 Code for Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema E11.331 E11.331 is a valid1 ICD 10 diagnosis code. E11.331 is NOT valid for submission for HIPAA-covered transactions. See below ↓ Chapter 4 Endocrine, nutritional and metabolic diseases (E00-E89) Section E08-E13 Diabetes mellitus (E08-E13) Category E11 Type 2 diabetes mellitus google_ad_client="ca-pub-1814926481161688";google_ad_slot="9344397369";google_ad_format="734x90_0ads_al";google_adsbygoogle_status="done";google_ad_width=734;google_ad_height=90;google_ad_resizable=true;google_override_format=1;google_responsive_auto_format=10;google_loader_features_used=128;google_ad_modifications={"plle":true,"eids":["21061122","191880502"],"loeids":[]};google_loader_used="aa";google_reactive_tag_first=false;google_ad_unit_key="3481760299";google_ad_dom_fingerprint="1195395224";google_sailm=false;google_unique_id=2;google_async_iframe_id="aswift_1";google_start_time=1514612923662;google_pub_vars="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 Continue reading >>

Icd-10 Code For Type 2 Diabetes Mellitus With Moderate Nonproliferative Diabetic Retinopathy Without Macular Edema

Icd-10 Code For Type 2 Diabetes Mellitus With Moderate Nonproliferative Diabetic Retinopathy Without Macular Edema

AAPC Coder Complete provides all the coding and reimbursement tools needed for inpatient coders, outpatient coders and CDI experts. Quickly view the OPPS fee schedules for freestanding ASCs and hospital based outpatient services in one place. For each CPT code, you can identify the applicable modifiers, status indicators and payment indicators. For procedures that require devices, you can view if there is a credit adjustment policy for the device. Avoid bundling and determine proper modifier use by using the Medicare OPPS CCI checker for up to 25 codes at one time. The cross-reference tools allow you to forward and backward map CPT to ICD-9-CM Volume 1 and 3, ICD-9-CM Volume 1 to ICD-10-CM and ICD-9-CM Volume 1 to the appropriate DRG options. Easily identity the DRG options, including CC and MCC, for each ICD-9-CM Volume 1 code. APC look up provides necessary detail on one page including long descriptor, payment and coverage info and more. CPT Assistant is the official word from the AMA on proper CPT code usage. AAPC Coder's Code Connect add-on allows you to search all CPT Assistant articles from 1990 to present by CPT code to narrow the options to only related articles for quick coding guidance. The HCPCS Coding Clinic delivers the official guidance published quarterly by the American Hospital Association (AHA) Central Office on correct HCPCS level II code usage. Each issue offers consistent and accurate advice for the proper use of HCPCS and includes information on HCPCS reporting for hospitals HCPCS Level 1 (CPT) and Level II codes, the latest code assignments from emerging technologies, and real examples. Continue reading >>

New Diabetes-related Diagnosis Codes You Need To Know

New Diabetes-related Diagnosis Codes You Need To Know

New diabetes-related diagnosis codes you need to know Ask the Coding Experts, by Doug Morrow, O.D., Harvey Richman, O.D., Rebecca Wartman, O.D. From the November/December 2016 edition of AOA Focus , page 48-49. On Oct. 1, 2016, hundreds of new ICD-10 codes that impact doctors of optometry went into effect. Several additions and revisions have been made in Chapter 4 of the ICD-10 code set (endocrine, nutritional and metabolic diseases). This chapter includes diabetes-related diagnosis codes. Because doctors of optometry perform the majority of comprehensive, dilated eye examinations for people with diabetes in the United States and are well versed in the treatment and management of diabetic eye disease, it is critical that doctors of optometry are aware of these updated codes. In addition to the diabetes code changes, many other code changes have occurred. Included in this column are just a few of these important changes. New 'code additional' requirements for type II diabetes (E11) The ICD-10 guidelines provide direction on the sequence for reporting certain conditions. The guidelines indicate, "Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a 'use additional code' note at the etiology code and a 'code first' note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation." For type II diabetes (E11), the "use additional" instructions have changed. Previously physicians were guided to use an additional code to identify any in Continue reading >>

Icd-10-cm And Cpt Changes In 2017

Icd-10-cm And Cpt Changes In 2017

November/ December 2016 ICD-10-CM CHANGES The proliferation of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for 2017 is especially relevant for retina practices, particularly the codes found in Chapter 4.1 New diagnosis codes should be in use now (started October 1), and the Centers for Medicare and Medicaid Services (CMS) has stated that they should be used from October 1 through September 30, 2017. Codes that do not change will continue to be used going forward. CMS was lenient in 2016 in allowing the use of codes with the description unspecified. In ICD-10-CM jargon, unspecified means the laterality or specificity of the diagnosis was not noted in the chart, not that it is unspecified clinically. Practices can expect claim denials if unspecified codes continue to be used. Codes that are more helpful are now in the book, but they are not necessarily where you would expect to find them. For example, codes for combined traction and rhegmatogenous retinal detachments can be found in Chapter 4 (Endocrine, Nutritional and other Metabolic Diseases) under diabetes, not in Chapter 7 (Diseases of the Eye and Adnexa). Chapter 4 also contains codes for use when a disease process has been treated and for disease that is stable. It is important for all physicians in a practice to review these changes because billing, coding, and payment will depend on the necessary information being documented in the chart. GUIDELINES The following is not a comprehensive list of all the changes for this year. Practices are advised to purchase and review the 2017 book.1 Diabetes mellitus has been abbreviated as DM. All descriptors have been abbreviated. Indented codes on this list are read with the beginning descriptor of the prior code. The hyphe Continue reading >>

2012 Icd-9-cm Diagnosis Code 362.05 : Moderate Nonproliferative Diabetic Retinopathy

2012 Icd-9-cm Diagnosis Code 362.05 : Moderate Nonproliferative Diabetic Retinopathy

Moderate nonproliferative diabetic retinopathy Short description: Mod nonprolf db retinoph. ICD-9-CM 362.05 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 362.05 should only be used for claims with a date of service on or before September 30, 2015. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes). You are viewing the 2012 version of ICD-9-CM 362.05. Convert to ICD-10-CM : 362.05 converts approximately to: 2015/16 ICD-10-CM E11.339 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema Diabetes type 1 with moderate retinopathy Diabetes type 2 with moderate retinopathy DM 1 w moderate nonproliferative diabetic retinopathy DM 1 w moderate nonproliferative diabetic retinopathy w macular edema DM 2 w moderate nonproliferative diabetic retinopathy DM 2 w moderate nonproliferative diabetic retinopathy w macular edema Drug induced diabetes with moderate retinopathy Drug induced DM w moderate nonproliferative diabetic retinopathy Drug induced DM w moderate nonproliferative diabetic retinopathy w macular edema Moderate nonproliferative diabetic retinopathy with macular edema due to drug-induced diabetes mellitus Moderate nonproliferative diabetic retinopathy without macular edema due to drug-induced diabetes mellitus Moderate nonproliferative retinopathy due to type 1 diabetes mellitus Moderate nonproliferative retinopathy due to type 2 diabetes mellitus Moderate non-proliferative retinopathy with due to secondary diabetes mellitus Moderate non-proliferative retinopathy with macular edema due to secondary diabetes mellitus Moderate nonproliferative retinopathy with macular edema due to type 1 diabetes mellitus Moderate nonp Continue reading >>

Top Icd-10-cm Changes: Diabetes, Glaucoma And Macular Degeneration

Top Icd-10-cm Changes: Diabetes, Glaucoma And Macular Degeneration

On October 1, 2016, changes to ICD-10-CM coding were implemented. While all of the code changes applicable for optometry are important, a few of the major changes are discussed in this article. Diabetic Ocular Complication Codes The first major change in ICD-10-CM codes for 2017 is for diabetic ocular complication coding. All of the DM retinopathy code choices will now specify which eye is impacted. Several new codes for proliferative diabetic retinopathy were also added. Note that a code for oral diabetic medication use (Z79.84) was added and should be used when applicable. The existing code to designate insulin use (Z79.4) was retained. Keep in mind that not all injectable diabetic medications are considered insulin. If a patient is on both oral medication and insulin, both of these medication codes should be used. The new codes for diabetic retinopathy apply to all the code categories, but only the E11.3 code section is detailed in this article so be sure to review the other categories if you are using them for any particular patient. The other categories include E08.3, E09.3, and E10.3. E11.3 Type 2 diabetes mellitus with ophthalmic complications All of the subcategories under E11.3, with two exceptions, will require a 7th character to indicate which eye had retinopathy. One exception is E11.36 Type 2 diabetes mellitus with diabetic cataract. The other exception is E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication, but this code does require the use of an additional code to further describe the complication. The ICD-10-CM tabular listing for each of the following subcategories will require the following 7th character to be added as indicated by this statement under each subcategory: E11.32, E11.33, E11.34, and E11.35. As an example, all of Continue reading >>

Icd-10, Part 4: How To Code For Diabetic Retinopathy

Icd-10, Part 4: How To Code For Diabetic Retinopathy

Written By: Elizabeth Cottle, CPC, OCS, Rajiv R. Rathod, MD, MBA, Sue Vicchrilli, COT, OCS, and E. Joy Woodke, COE, OCS Finding the ICD-10 codes for diabetic retinopathy can be tricky. They are not listed in Chapter 7, Diseases of the Eye and Adnexa (H00-H59), but are in the diabetes section (E08-E13) of Chapter 4, Endocrine, Nutritional and Metabolic Diseases. Retinal complications. To further confuse matters, the most common retinal complications are in Chapter 7, not Chapter 4. Examples include vitreous hemorrhage (H43.1-), traction detachment of retina (H33.4-), and rubeosis iridis (H21.1-). New options. ICD-10 features codes for diagnoses that don’t currently have codes. These include drug- or chemical-induced diabetes mellitus (E09.-); gestational diabetes (Q24.4-); neonatal diabetes mellitus (P70.2); and postpancreatectomy, postprocedural, or secondary diabetes mellitus (E13.-). Changes in Documentation Some terms that you’re using in charts—such as “NIDDM,” “controlled,” and “uncontrolled”—will be obsolete when ICD-10 starts on Oct. 1, 2015. Instead, diabetes documentation should address the following questions: Is it type 1 or type 2? Is there diabetic retinopathy? If so, is it proliferative or nonproliferative? If nonproliferative, is it mild, moderate, or severe? Is there macular edema? Preparedness tips. To help you work through that series of questions, the AAOE has developed a decision tree that you can laminate and keep for reference at the coder’s desk. Download it at www.aao.org/icd10. You also should update your intake form so that staff can capture the type of diabetes. Insulin use? Submit Z79.4 as supporting documentation indicating any insulin use. What’s the Underlying Condition? According to ICD-10 instructions, physicians Continue reading >>

Icd-10-cm/pcs Ms-drg V35.0 Definitions Manual

Icd-10-cm/pcs Ms-drg V35.0 Definitions Manual

ICD-10-CM/PCS MS-DRG v35.0 Definitions Manual Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral Other specified diabetes me Continue reading >>

E11.3412 Type 2 Diabetes Mellitus With Severe Nonproliferative Diabetic Retinopathy With Macular Edema, Left Eye

E11.3412 Type 2 Diabetes Mellitus With Severe Nonproliferative Diabetic Retinopathy With Macular Edema, Left Eye

E11.3412 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye Synonym for Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye E00-E89 Endocrine, nutritional and metabolic diseases (E00-E89)|E08-E13 Diabetes mellitus (E08-E13)|E11 Type 2 diabetes mellitus|E11.3 Type 2 diabetes mellitus with ophthalmic complications|E11.34 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy|E11.341 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema Results for Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye and additional synonyms Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye All content of the ICD-10 CM Search is based on the classifications and codes of the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) . The accumulation of synonyms is carried out by Averbis GmbH with Healthcare Natural Language Processing . All information is provided without guarantee. Errors and omissions excepted. We expressly reserve the right to make changes, additions or deletions to the information or links provided at any time without prior notice. Our offer is non-binding. For correctness, completeness and topicality or designations no liability is assumed. ICD-Search IC Continue reading >>

E11.321-351 Diabetic Macular Edema

E11.321-351 Diabetic Macular Edema

E11.321Mild nonproliferative diabetic retinopathy,with macular edema E11.331Moderate nonproliferative diabetic retinopathy,with macular edema E11.341Severe nonproliferative diabetic retinopathy,with macular edema E11.351Proliferative diabetic retinopathy,with macular edema A complication of diabetes that occurs when microaneurysms or dilated retinal capillaries leak fluid into the retina. Diabetes mellitus is a complex, multifactorial and heterogeneous group of disorders characterized by endogenous insulin deficiency and/or insulin resistance. The diseasemanifests itself as a state of chronic hyperglycemia with attendant microvascular and macrovascular complications. Macular edema may be present in any stage of diabetic retinopathy and is defined as any one of the following: Retinal thickening within 500 microns of the foveal center Hard exudates within 500 microns of the foveal center, if associated with the thickening of the adjacent retina Retinal thickening greater than one disc area in size, part of which is within one discdiameterof the center of the macul Walls of the blood vessels in the retina become fragile and weakened Weakened blood vessels have an increase in vascular permeability Lipid deposits form in the retinal tissue secondary to chronic edema Report seeing spots or floaters in field of view Report dark or empty spot in the central vision The main goal of the diagnostic evaluation in a patient with diabetic retinopathy is to accomplish the following: Determine the presence or absence of clinically significant macular edema If present, classify the severity of themacular edema Identify and exclude differential diagnosis The severity of the symptoms or signs isvaried and dependson the level of control the patient has over their diabetes. Patients can pr Continue reading >>

Icd-10 Doesn't Have To Be Intimidating

Icd-10 Doesn't Have To Be Intimidating

To help internists become even more comfortable with the new code set, ACP looks at how the codes are structured and how to cross-walk from old to new for some of the most common ones. The idea of a new code set should be familiar by now to internists. To help internists become even more comfortable with ICD-10, this column will answer questions that ACP has received from members by offering examples of the codes for common diagnoses. Q: What are the differences in the structures of ICD-9 versus ICD-10 codes? Are the code numbers random, or do they follow some type of order? A: ICD-10 uses 3 to 7 alphabetic and numeric characters and full code titles, but the format is very similar to that of ICD-9. ICD-10 uses codes that are longer (in some cases) than those of ICD-9, following a basic structure: characters 1-3 will now refer to the code category; characters 4-6 will cover clinical details such as severity, etiology, and anatomic site (among others) and are alphabetic or numeric and character 7 will serve as an extension when necessary and will be either alphabetic or numeric. For illustration, here are a few brief crosswalks from ICD-9 to ICD-10 coding. In ICD-9, headache is coded as 784.0; in ICD-10, it is coded as R51. ICD-9 uses 724.5 for backache, unspecified, while ICD-10 uses the following more specific codes: M54.9, dorsalgia, unspecified; M54.89, other dorsalgia; M54.6, pain in thoracic spine; M54.5, low back pain; and M53.3, sacrococcygeal disorders, not elsewhere classified. For atrial fibrillation, ICD-9 uses the code 427.31, while ICD-10 uses the following more specific codes: I48.0, paroxysmal atrial fibrillation; I48.1, persistent atrial fibrillation; I48.2, chronic atrial fibrillation; and I48.91, unspecified atrial fibrillation. Q: I've heard that ICD Continue reading >>

Coding For Diabetic Retinopathy

Coding For Diabetic Retinopathy

For The Record Vol. 24 No. 17 P. 26 Diabetic retinopathy is a complication of long-term diabetes resulting from changes in the blood vessels of the retina. The condition may start with no symptoms or only mild vision problems, but it may eventually lead to blindness. Diabetic retinopathy is the leading cause of blindness in working-age Americans. The longer a patient has diabetes, the greater the risk he or she will experience diabetic complications such as diabetic retinopathy. Preventive measures include maintaining well-controlled blood sugars and regularly scheduling eye exams. Poorly controlled blood sugars may affect the capillaries in the eye. If a patient is admitted with diabetic retinopathy or has retinopathy due to diabetes, the diabetic code (ICD-9-CM category 250) must be sequenced as the principal diagnosis followed by the code for the specific type of retinopathy as a secondary diagnosis. The physician must state a cause and effect relationship between the retinopathy and the diabetes before the retinopathy can be coded as a diabetic condition. Diabetes with ophthalmic manifestations is assigned to diabetic code 250.5. Other ophthalmic manifestations include the following: • blindness (369.00 to 369.9); • cataract (366.41); • glaucoma (365.44); • iritis/iridis rubeosis (364.42); • macular edema (362.07; also assign a code for the diabetic retinopathy, 362.01 to 362.06); • orbital osteomyelitis (376.03); • retinal edema (362.07; also assign a code for the diabetic retinopathy); • retinopathy (362.01 to 362.07); and • rubeosis iridis (364.42). Code 250.5 requires a fifth-digit subclassification to identify the type of diabetes and the control status as follows: • 0: type 2 or unspecified type, not stated as uncontrolled; • 1: type 1 (j Continue reading >>

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