2025 ICD-10-CM code E11.39
(Active) Effective Date: N/A Endocrine, Nutritional and Metabolic Diseases - Diabetes mellitus 4 Feed
Type 2 diabetes mellitus with other diabetic ophthalmic complication. Use additional code to identify manifestation, such as diabetic glaucoma (H40-H42).
Medical necessity must be established by documenting the diagnosis of type 2 diabetes and linking the presented ophthalmic complication directly to the diabetic condition, ruling out any non-diabetic cause. Any diagnostic procedures or treatments provided should be justified by clinical findings and appropriate guidelines.
Physicians diagnose based on patient history, physical and ophthalmic examinations, and symptoms. Laboratory tests (blood glucose, HbA1c, lipid panel, urine), and imaging (X-ray, ultrasound, fluorescein angiography, OCT, fundus photography) are used for diagnosis and monitoring. Treatment focuses on metabolic and blood pressure control, including laser photocoagulation, anti-VEGF medication, steroids, and sometimes surgery (vitrectomy). Management of the underlying diabetes involves non-insulin and/or insulin therapies.
In simple words: This code refers to type 2 diabetes with eye problems other than cataracts, retinopathy, or macular edema.It signifies that the body isn't processing sugar properly which is causing issues with the eyes.
Type 2 diabetes mellitus with other diabetic ophthalmic complications refers to a condition where the body does not effectively produce or utilize insulin, resulting in elevated blood sugar levels and eye complications other than diabetic cataract, retinopathy, and macular edema.
Example 1: A patient with type 2 diabetes presents with neovascular glaucoma, confirmed by ophthalmological examination and intraocular pressure measurement., A patient with type 2 diabetes experiences recurrent ocular infections and inflammation not associated with retinopathy. Upon examination, they are diagnosed with diabetic ophthalmic complication., A patient with type 2 diabetes develops cranial nerve palsy affecting eye movement. After ruling out other causes, the condition is attributed to a diabetic ophthalmic complication.
Documentation should include details of the ophthalmic complication, the type and stage of the patient’s diabetes, related symptoms and physical exam findings, results of laboratory tests including HbA1c and blood glucose, results of ophthalmic examinations and imaging studies, medical necessity for treatments, treatment plans, any relevant comorbidities, and patient’s response to treatment.
- Specialties:Endocrinology, Ophthalmology
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home