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BETA v.3.0

2025 ICD-10-CM code E10.321

Type 1 diabetes with mild nonproliferative diabetic retinopathy (NPDR) and macular edema.

Use additional codes to specify the laterality (right eye, left eye, or bilateral) using the 7th character of the code.If other diabetic complications are present, use additional codes to document those as well.

Use the 7th character to specify laterality:1 - Right eye2 - Left eye3 - Bilateral9 - Unspecified eye

Medical necessity for services related to E10.321 is established by the presence of type 1 diabetes, mild NPDR, and macular edema. Treatment is necessary to prevent vision loss and further complications.

Diagnosis and management of this condition typically involves endocrinologists, ophthalmologists, and primary care physicians. Endocrinologists manage the underlying diabetes, while ophthalmologists specialize in treating eye conditions like diabetic retinopathy. Primary care physicians play a crucial role in coordinating care and monitoring overall health.

In simple words: This code describes a type of eye damage (retinopathy) caused by type 1 diabetes, where the central part of the eye (macula) responsible for sharpest vision becomes swollen.

Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema. This condition involves damage to the retinal blood vessels due to chronically high blood glucose levels, leading to microaneurysms, hemorrhages, and swelling of the macula (the central part of the retina responsible for sharp vision).

Example 1: A patient with a long-standing history of type 1 diabetes presents with blurred vision and recent onset of macular edema confirmed by ophthalmological examination., A routine eye exam for a type 1 diabetic patient reveals mild NPDR and macular edema. The patient reports no noticeable vision changes., An adolescent newly diagnosed with type 1 diabetes undergoes an eye exam which reveals no retinopathy initially, however mild NPDR and macular edema is found a year later.

Documentation should include: type 1 diabetes diagnosis, details of the ophthalmological examination (e.g., fundus photography, fluorescein angiography), presence and severity of NPDR, presence of macular edema, and any associated symptoms (e.g., blurred vision).

** Regular monitoring of diabetes and annual eye exams for diabetic retinopathy are crucial for early detection and management.

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