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BETA v.3.0

2025 ICD-10-CM code E08.3212

Diabetes mellitus due to an underlying condition with mild nonproliferative diabetic retinopathy and macular edema of the left eye.

Code first the underlying condition causing the diabetes.Use additional codes to specify diabetes control methods (e.g., insulin, oral medications).

Medical necessity for care related to this code is established by the diagnosis of diabetes, the underlying condition causing the diabetes, and the presence of NPDR and macular edema.Treatment is deemed necessary to manage the diabetes, prevent further vision loss, and address the underlying condition.

Clinicians should assess and document the underlying condition causing the diabetes, the severity of NPDR, and the presence and extent of macular edema.They should also evaluate and manage other potential complications of diabetes.

In simple words: This diagnosis means you have diabetes caused by another health problem.It also means you have mild damage to the blood vessels in the back of your left eye, causing swelling and blurred vision.

This code specifies a type of diabetes resulting from an underlying condition, accompanied by mild nonproliferative diabetic retinopathy (NPDR) with macular edema affecting the left eye.NPDR is a diabetic eye complication where damage is limited to the retina and includes microaneurysms, hemorrhages, and intraretinal microvascular abnormalities. Macular edema is the accumulation of fluid in the macula, the part of the eye responsible for sharp central vision. This code signifies that the patient has mild NPDR and macular edema specifically in their left eye.

Example 1: A patient with cystic fibrosis develops diabetes and is subsequently diagnosed with mild NPDR and macular edema in their left eye., A patient receiving chemotherapy for pancreatic cancer develops diabetes as a side effect.During an eye exam, mild NPDR and macular edema are found in the left eye., A patient with long-standing Cushing's syndrome develops diabetes and mild NPDR with macular edema in their left eye.

Documentation should include the underlying cause of diabetes, detailed eye exam findings including the presence and severity of NPDR and macular edema, and the laterality (left eye).Any associated symptoms and treatment plans should also be documented.

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