ICD-10-CM Billable Code

E13.311

Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema

Clinical Classification Guidelines

Medical Intelligence & Overview

ICD-10 code E13.311 refers to a specific type of diabetes mellitus that involves eye complications. This condition combines a form of diabetes not classified under type 1 or type 2, characterized by diabetic retinopathy with additional swelling in the central part of the retina, known as macular edema. Diabetic retinopathy is a common complication of diabetes, affecting the blood vessels in the retina, which can lead to vision problems or loss if not managed appropriately. When macular edema is present, it indicates swelling in the retina's central area, which is essential for sharp vision. Understanding this condition helps in recognizing its symptoms, causes, and treatment options to improve quality of life.

Causes & Symptoms

Clinical Causes: Prolonged high blood sugar levels resulting from inadequate management of diabetes Damage to the blood vessels in the retina due to chronic hyperglycemia Presence of other metabolic factors such as high blood pressure or high cholesterol that can exacerbate vascular damage Duration of diabetes; longer periods of uncontrolled diabetes increase risk Genetic predisposition that may influence susceptibility to diabetic eye complications

Key Symptoms: Blurred or cloudy vision Dark spots or floaters in the vision field Difficulty perceiving colors accurately Sudden vision loss in severe cases Fellow eye may also be affected over time

Diagnostic & Treatment

Diagnosis Path: Diagnosing this condition involves a comprehensive eye examination, which typically includes:

Treatment Protocols: Managing this eye condition aims to prevent vision loss and improve eye health. Treatment options include:

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is E13.311 a billable ICD-10 code?
Yes, E13.311 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report E13.311?
Clinical documentation must specify the nature of Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema and any associated comorbidities for accurate reporting.

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Clinical Meta Tags

macular edema diabetic retinopathy mellitus diabetes