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Home/Diagnosis/ICD-10 Coding for Diabetic Retinopathy

ICD-10 Coding for Diabetic Retinopathy

E11.3293
E11.3413

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

Also Known as:
Diabetic Eye Disease
Diabetic Retinal Disease
diabetes with retinopathy
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Key Information: ICD-10 Coding for Diabetic Retinopathy

Essential facts and insights about ICD-10 Coding for Diabetic Retinopathy

Use ICD-10 code E11.3293 for type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral

Billable Code
E11.3293
Billable

Diagnostic Criteria

  • • Documented absence of macular edema and presence of mild NPDR.

Applicable To

  • • Mild NPDR without macular edema, bilateral

Important Notes

  • • Ensure documentation specifies the absence of macular edema.

Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral

Billable Code
E11.3413
Billable

Diagnostic Criteria

  • • Fundus exam showing severe NPDR changes
  • • OCT confirming macular edema

Applicable To

  • • Severe NPDR with macular edema, bilateral

Important Notes

  • • Ensure documentation specifies the presence of macular edema.
Ancillary Codes

Additional codes that may be used with this diagnosis

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 retinopathy?

The ICD-10 code for diabetic retinopathy varies based on severity and presence of macular edema, such as E11.3293 for mild NPDR without macular edema.

How do you code diabetic retinopathy with macular edema?

Use E11.3413 for type 2 diabetes with severe NPDR and macular edema, ensuring documentation supports the severity and edema presence.

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