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BETA v.3.0

2025 ICD-10-CM code E08.3213

Diabetes due to underlying condition with mild nonproliferative diabetic retinopathy (NPDR) with macular edema, bilateral.

Code first the underlying condition causing the diabetes. Use additional codes to specify the type of diabetes control (insulin, oral medication, etc.).

Medical necessity is established by the diagnosis of diabetes and the presence of mild NPDR with macular edema requiring medical intervention.

The provider should document the underlying condition causing the diabetes, the presence of mild NPDR with macular edema in both eyes, and the treatment plan.

In simple words: This code describes diabetes caused by another medical problem, along with mild diabetic eye disease affecting the macula of both eyes.

Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral. Code first the underlying condition, such as: congenital rubella (P35.0), Cushing's syndrome (E24.-), cystic fibrosis (E84.-), malignant neoplasm (C00-C96), malnutrition (E40-E46), pancreatitis and other diseases of the pancreas (K85-K86.-). Use additional code to identify control using: injectable non-insulin antidiabetic drugs (Z79.85), insulin (Z79.4), oral antidiabetic drugs (Z79.84), oral hypoglycemic drugs (Z79.84).

Example 1: A patient with cystic fibrosis develops diabetes and is found to have mild NPDR with macular edema in both eyes., A patient with pancreatic cancer develops diabetes and is also diagnosed with mild NPDR with macular edema bilaterally., A patient with Cushing's syndrome develops diabetes and is found to have mild NPDR with macular edema in both eyes.

Diagnosis of diabetes due to underlying condition; Confirmation of mild NPDR with macular edema in both eyes through ophthalmological examination; Documentation of the underlying condition causing the diabetes; Treatment plan.

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