ICD-10-CM Billable Code

E11.353

Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula

Clinical Classification Guidelines

Medical Intelligence & Overview

Type 2 diabetes mellitus is a chronic condition that affects how your body processes blood sugar (glucose). When diabetes is not well-managed, it can lead to various complications, including damage to the eyes. One such complication is diabetic retinopathy, a condition that affects the retina—the light-sensitive tissue at the back of your eye. Specifically, ICD-10 code E11.353 describes a severe form called proliferative diabetic retinopathy, which can sometimes lead to traction retinal detachment, but notably, this does not involve the central part of the retina known as the macula. Recognizing and understanding this condition is essential for early intervention and management.

Causes & Symptoms

Clinical Causes: Prolonged high blood sugar levels associated with type 2 diabetes Duration of diabetes, with longer durations increasing risk Poor blood sugar control over time High blood pressure and high cholesterol levels, which can worsen eye damage Smoking, which contributes to blood vessel damage Genetic factors that predispose some individuals to eye complications

Key Symptoms: Gradual loss of vision or blurred vision Floaters or patches in the visual field Sudden appearance of dark or red spots in the vision Changes in color perception Difficulty seeing in low light conditions No obvious symptoms in the early stages; vision might remain normal until significant damage occurs

Diagnostic & Treatment

Diagnosis Path: Diagnosis typically involves a comprehensive eye examination by an eye care professional. This may include:

Treatment Protocols: Managing proliferative diabetic retinopathy with traction retinal detachment involves a combination of treatments aimed at preventing further damage and attempting to restore vision. Approaches may 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 E11.353 a billable ICD-10 code?
Yes, E11.353 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report E11.353?
Clinical documentation must specify the nature of Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula and any associated comorbidities for accurate reporting.

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Clinical Meta Tags

traction proliferative diabetic retinal retinopathy mellitus detachment macula diabetes