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Home/Diagnosis/ICD-10 Coding for Diabetic Macular Edema

ICD-10 Coding for Diabetic Macular Edema

E11.321
E11.351

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

Also Known as:
DME
Diabetic Retinal Edema
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Key Information: ICD-10 Coding for Diabetic Macular Edema

Essential facts and insights about ICD-10 Coding for Diabetic Macular Edema

Use ICD-10 code E11.321 for type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema

Non-Billable
E11.321
Non-Billable

Diagnostic Criteria

  • • Presence of mild NPDR with macular edema confirmed by OCT.

Applicable To

  • • Mild NPDR with macular edema

Important Notes

  • • Ensure documentation includes severity and laterality of retinopathy.

Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema

Non-Billable
E11.351
Non-Billable

Applicable To

  • • Proliferative DR with macular edema

Important Notes

  • • Document neovascularization and macular edema clearly.
Ancillary Codes

Additional codes that may be used with this diagnosis

N18.3

Chronic kidney disease, stage 3

Use when CKD is present as a comorbidity.

Z79.4

Long term (current) use of insulin

Use when the patient is on insulin therapy.

Frequently Asked Questions

What is the ICD-10 code for diabetic macular edema?

The ICD-10 code for diabetic macular edema varies based on the type and severity of retinopathy, such as E11.321 for mild NPDR with macular edema.

How do you document diabetic macular edema?

Document diabetic macular edema by specifying the type of diabetes, retinopathy severity, laterality, and OCT findings.

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