2025 ICD-10-CM code E09.359
Diabetes mellitus due to drugs or chemicals, with proliferative diabetic retinopathy without macular edema.
Medical necessity is established by the presence of diabetes mellitus directly caused by medication use, along with the presence of proliferative diabetic retinopathy without macular edema confirmed by ophthalmological examination. The documentation must clearly link the medication use to the development of both conditions.
The provider is responsible for identifying the causative medication, managing blood sugar levels, treating the retinopathy, and educating the patient about potential complications and long-term management.
In simple words: This type of diabetes is caused by certain medications.It leads to high blood sugar and eye problems, specifically the growth of new, fragile blood vessels in the retina, which can cause bleeding.The central part of the eye (macula) is not affected by swelling. Symptoms can include vision changes, eye pain, and typical diabetes symptoms.
Drug–or chemical–induced diabetes mellitus (DM) with proliferative diabetic retinopathy (PDR) without macular edema is a secondary type of diabetes.It's characterized by abnormally high blood sugar levels due to medication side effects, resulting in retinal disorder with new blood vessel growth on the retina, but without macular edema.This condition is often linked to long-term use of medications like antidepressants, antipsychotics, thiazide diuretics, or steroids.
Example 1: A patient on long-term steroid therapy for rheumatoid arthritis develops elevated blood glucose levels and blurred vision.Ophthalmological examination reveals proliferative diabetic retinopathy without macular edema., A patient with schizophrenia, treated with antipsychotics for several years, presents with increased thirst, frequent urination, and vision changes. Diagnostic tests confirm drug-induced diabetes mellitus with proliferative diabetic retinopathy without macular edema., A patient taking high doses of corticosteroids for an extended period develops symptoms of diabetes and is diagnosed with proliferative diabetic retinopathy without macular edema.
Documentation should include the type of medication causing the diabetes, duration of medication use, blood glucose levels, HbA1c levels, details of the ophthalmological exam, including findings of proliferative retinopathy without macular edema, and other related symptoms.
** This code specifically excludes macular edema.If macular edema is present, a different code should be used.Also, if the diabetes is due to an underlying condition, other codes (E08.-) should be used instead.
- Specialties:Endocrinology, Ophthalmology, Internal Medicine
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital,Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home