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BETA v.3.0

2025 ICD-10-CM code E09.311

Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema.

Code first the poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4).Use additional codes to identify control of diabetes (e.g., insulin (Z79.4), oral antidiabetic drugs (Z79.84)).

The medical necessity for this code is established by the confirmed diagnoses of drug or chemical-induced diabetes mellitus with the added complication of retinopathy and macular edema.

In simple words: This refers to diabetes caused by medication or chemicals, leading to eye damage (retinopathy) and swelling in a part of the eye called the macula.

This code describes a condition where a patient has diabetes mellitus caused by a drug or chemical, along with diabetic retinopathy and macular edema. The specific type of diabetic retinopathy is not specified.

Example 1: A patient with schizophrenia develops diabetes after taking antipsychotic medication for an extended period.They are subsequently diagnosed with diabetic retinopathy and macular edema.The specific type of retinopathy is not documented., A patient with long-term steroid use for rheumatoid arthritis develops drug-induced diabetes.On examination, they are found to have both diabetic retinopathy and macular edema, but the type of retinopathy is not specified in the ophthalmologist's report., A patient on thiazide diuretics for high blood pressure develops drug-induced diabetes. Routine eye examination reveals diabetic retinopathy with macular edema, though the specific stage and type of retinopathy isn’t yet determined.The physician uses E09.311 as the diagnosis code.

Diagnosis of drug or chemical induced diabetes mellitus. Documentation of diabetic retinopathy and macular edema.The causative drug or chemical should be specified in the medical record. If known, the type of diabetic retinopathy should also be documented.

** For more specific types of diabetic retinopathy with macular edema, use the appropriate codes under E08, E09, E10, E11, or E13.

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