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BETA v.3.0

2025 ICD-10-CM code E10.3

Type 1 diabetes mellitus with ophthalmic complications.

Code E10.3 should be used as a secondary code to the specific eye condition diagnosed.It is not appropriate to use this code alone. Ensure documentation clearly links the eye condition to the patient's diabetes.

Medical necessity for services related to E10.3 is established by the presence of documented diabetic ophthalmic complications.Regular eye exams are medically necessary for all patients with type 1 diabetes due to the high risk of developing eye disease.

Diagnosis and management of type 1 diabetes and its associated ophthalmic complications require the expertise of various healthcare professionals, including endocrinologists, ophthalmologists, optometrists, primary care physicians, diabetes educators, and dietitians. Endocrinologists manage the underlying diabetes through medication, insulin therapy, and lifestyle counseling. Ophthalmologists and optometrists specialize in diagnosing and treating eye conditions, such as retinopathy, cataracts, glaucoma, and other visual disturbances resulting from diabetes. They perform comprehensive eye exams, including visual acuity tests, dilated retinal examinations, and other diagnostic procedures. Primary care physicians play a crucial role in ongoing monitoring and coordinating care between specialists. Diabetes educators provide patient education on blood glucose management, self-care strategies, and the importance of regular eye checkups. Dietitians offer guidance on meal planning and dietary adjustments to support diabetes management. Collaborative efforts among these healthcare professionals ensure comprehensive care for individuals with type 1 diabetes and its related eye complications.

In simple words: This code indicates that a patient has type 1 diabetes, an autoimmune disease where the body doesn't produce insulin, and is experiencing eye problems as a result of the diabetes. These eye problems can vary in severity and may include conditions like blurry vision, cataracts, and damage to the blood vessels in the back of the eye (retinopathy).

This code signifies that the patient has type 1 diabetes mellitus and is experiencing complications affecting the eyes.These complications can range from cataracts and retinopathy (damage to the blood vessels in the retina) to glaucoma and other visual disturbances.It's important to note that this code indicates the presence of both type 1 diabetes and related eye issues, and not just one or the other.

Example 1: A patient with a long history of type 1 diabetes presents with blurred vision and floaters. Upon examination, the ophthalmologist diagnoses proliferative diabetic retinopathy., A young patient recently diagnosed with type 1 diabetes undergoes a routine eye exam and is found to have mild nonproliferative diabetic retinopathy., An elderly patient with poorly controlled type 1 diabetes develops cataracts, which are determined to be accelerated due to the underlying diabetes.

Documentation for E10.3 should include the type and stage of diabetic retinopathy, any other ophthalmic complications, the patient's HbA1c level, and any treatments provided, such as laser photocoagulation or anti-VEGF injections.Detailed ophthalmological examination findings are essential.

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