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Home/Diagnosis/ICD-10 Coding for Diabetic Eye Exam

ICD-10 Coding for Diabetic Eye Exam

E10.3211
E11.359

Complete ICD-10-CM coding and documentation guide for icd-10 coding for diabetic eye exam includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Diabetic Retinal Exam
Diabetic Ophthalmic Examination
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Key Information: ICD-10 Coding for Diabetic Eye Exam

Essential facts and insights about ICD-10 Coding for Diabetic Eye Exam

Use ICD-10 code E10.3211 for type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye

Billable Code
E10.3211
Billable

Diagnostic Criteria

clinical:
  • • Presence of macular edema confirmed by OCT
documentation:
  • • Detailed description of NPDR severity and laterality

Applicable To

  • • Mild NPDR with macular edema in right eye

Important Notes

  • • Ensure documentation specifies the presence of macular edema and laterality.

Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema

Non-Billable
E11.359
Non-Billable

Applicable To

  • • Proliferative diabetic retinopathy without macular edema

Important Notes

  • • Document the absence of macular edema clearly.
Ancillary Codes

Additional codes that may be used with this diagnosis

Z79.4

Long-term (current) use of insulin

Use to indicate insulin use in diabetic patients.

Frequently Asked Questions

What is the ICD-10 code for a diabetic eye exam?

The ICD-10 code for a diabetic eye exam varies based on the type of diabetes and presence of complications, such as E10.3211 for Type 1 diabetes with mild NPDR and macular edema.

How do you code diabetic retinopathy?

Code diabetic retinopathy by specifying the type of diabetes, severity of retinopathy, and presence of macular edema, using codes like E11.359 for Type 2 diabetes with proliferative retinopathy.

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