2025 ICD-10-CM code E08.319
(Active) Effective Date: N/A Endocrine, Nutritional and Metabolic Diseases - Diabetes mellitus due to underlying condition with retinopathy 4 Feed
Diabetes mellitus due to an underlying condition with unspecified diabetic retinopathy without macular edema.
The medical necessity for this code is established by the presence of diabetes due to an underlying condition, along with diabetic retinopathy without macular edema. The underlying condition should be clearly documented and linked to the diabetes diagnosis.
Diabetic retinopathy is a complication of diabetes affecting the retina, causing blocked blood vessels and abnormal vessel growth. Macular edema is fluid buildup in the macula, responsible for sharp vision. Patients may experience eye pain, blurred vision, double vision, retinal detachment, headache, cataracts, dizziness, increased urination and thirst, extreme hunger, fatigue, weight loss, and frequent infections. Other symptoms depend on the underlying condition and can include weakness, pain, breathing difficulties, loss of appetite, anemia, high blood pressure, and night sweats. Diagnosis involves history, physical and eye exams, blood tests (fasting plasma glucose, lipid profile), urine and stool analysis, and abdominal imaging. Treatment addresses the underlying cause, potentially with eye surgery, corticosteroids, radiation, chemotherapy, antibiotics, or surgery. Diabetes is managed with insulin or non-insulin therapies.
In simple words: This code signifies diabetes resulting from an underlying health issue, accompanied by a general type of diabetic eye damage (retinopathy) that doesn't involve swelling in the central part of the retina (macula).
Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema refers to a disease in which the body's production or utilization of insulin is insufficient, leading to high levels of blood glucose and subsequent diabetic retinopathy without macular edema. Major underlying causes are cystic fibrosis, malignant neoplasm, malnutrition, pancreatitis, and Cushing syndrome.
Example 1: A patient with cystic fibrosis presents with high blood sugar and diabetic retinopathy, but no macular edema., A patient undergoing chemotherapy for a malignant neoplasm develops diabetes and unspecified diabetic retinopathy without macular edema., A patient with chronic pancreatitis experiences high blood sugar and is diagnosed with diabetic retinopathy without macular edema.
Documentation should specify the underlying condition causing diabetes, the presence of diabetic retinopathy, and the absence of macular edema. The type of retinopathy, if known, should also be documented.
- Specialties:Endocrinology, Ophthalmology
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital