Three Common Diabetes-related Eye Diseases & Their ICD-10 Codes

Diabetes is a complex metabolic disease that affects the body’s ability to produce or use insulin effectively to control blood sugar (glucose) levels. Sugar levels build up in your blood if you don’t have enough insulin to break it down. This is called hyperglycemia which can negatively affect every part of your body including your eyes. In most cases, blurry vision is one of the initial warning signs of diabetes. Your vision may become blurry as the fluid may leak into the lens of your eyes. This makes the lens swell and change shape which make it hard for the eyes to focus. The best way to keep your eyes healthy and prevent diabetes-related eye disease or avoid it from getting worse is to keep your diabetes under control. Consuming diabetic medications (as prescribed), staying physically active, focusing on a healthy diet and refraining from smoking can help control blood sugar levels which in turn would help reduce your risk of diabetic eye disease. For correct clinical documentation of this condition, ophthalmologists can utilize the services of professional medical billing companies.

Here discussed are the top three diabetes-related eye diseases and their ICD-10 codes –

Retinopathy – Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes. There are two major types of retinopathy – non-proliferative and proliferative. Non-proliferative means no abnormal blood vessels. In non-proliferative retinopathy, the most common form of retinopathy, capillaries at the back of the eye balloon and form pouches. Non-proliferative retinopathy can move through three stages (mild, moderate, and severe), as more and more blood vessels become blocked. In some stages, the capillary walls may lose their ability to control the passage of substances between the blood and the retina. Fluid can leak into the part of the eye where focusing occurs, the macula. When the macula swells with fluid, a condition called macula edema, your vision blurs and can be lost entirely. In the case of proliferative retinopathy, new abnormal blood vessels start growing in the retina. These new vessels are weak and can leak blood, blocking vision.

Typically, retinopathy caused by diabetes may not display any symptoms during its early stages. As the condition progresses, you will notice symptoms such as spots or dark strings floating in your vision (floaters), blurred or fluctuating vision, impaired color vision, dark or empty areas in your vision and vision loss. ICD-10 codes related to this eye disorder include –

Type 1 Diabetes, Non-proliferative Retinopathy

E10.31 – Type 1 diabetes mellitus with unspecified diabetic retinopathy
E10.32 – Type 1 diabetes mellitus with mild non-proliferative diabetic retinopathy

• E10.329 – Type 1 diabetes mellitus with mild non-proliferative diabetic retinopathy without macular edema

E10.33 – Type 1 diabetes mellitus with moderate non-proliferative diabetic retinopathy

• E10.339 – Type 1 diabetes mellitus with moderate non-proliferative diabetic retinopathy without macular edema

E10.34 – Type 1 diabetes mellitus with severe non-proliferative diabetic retinopathy

• E10.341 – Type 1 diabetes mellitus with severe non-proliferative diabetic retinopathy with macular edema
• E10.349 – Type 1 diabetes mellitus with severe non-proliferative diabetic retinopathy without macular edema

Type 1 Diabetes, Proliferative Retinopathy

E10.35 – Type 1 diabetes mellitus with proliferative diabetic retinopathy

• E10.351 – Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema
• E10.352 – Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula
• E10.353 – Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula
• E10.354 – Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
• E10.355 – Type 1 diabetes mellitus with stable proliferative diabetic retinopathy
• E10.359 – Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema

Type 2 Diabetes, Non-proliferative Retinopathy

E11.31 – Type 2 diabetes mellitus with unspecified diabetic retinopathy
E11.32 – Type 2 diabetes mellitus with mild non-proliferative diabetic retinopathy

• E11.321 – Type 2 diabetes mellitus with mild non-proliferative diabetic retinopathy with macular edema
• E11.329 – Type 2 diabetes mellitus with mild non-proliferative diabetic retinopathy without macular edema

E11.33 – Type 2 diabetes mellitus with moderate non-proliferative diabetic retinopathy

• E11.331 – Type 2 diabetes mellitus with moderate non-proliferative diabetic retinopathy with macular edema
• E11.339 – Type 2 diabetes mellitus with moderate non-proliferative diabetic retinopathy without macular edema

Type 2 Diabetes, Proliferative Retinopathy

E11.34 – Type 2 diabetes mellitus with severe non-proliferative diabetic retinopathy

• E11.341 – Type 2 diabetes mellitus with severe non-proliferative diabetic retinopathy with macular edema
• E11.349 – Type 2 diabetes mellitus with severe non-proliferative diabetic retinopathy without macular edema

E11.35 – Type 2 diabetes mellitus with proliferative diabetic retinopathy

• E11.351 – Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema
• E11.352 – Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula
• E11.353 – Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula
• E11.354 – Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment
• E11.355 – Type 2 diabetes mellitus with stable proliferative diabetic retinopathy
• E11.359 – Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema

Glaucoma – Glaucoma is a group of eye conditions that damage the optic nerve which connects the eye to the brain. This optic nerve damage often caused by an abnormally high pressure in the eyes may result in partial vision loss or blindness. Regarded as one of the leading causes of irreversible blindness, glaucoma currently affects more than 3 million people in the United States. The National Eye Institute estimates that this number will reach 4.2 million by the end of 2030 – reporting a 58 percent increase. The disease usually affects both eyes, although one may be more severely affected than the other. The eye disease can occur at any age, but is more common among older adults, above the age group of 60 years. Related symptoms include blurred vision, severe headache, eye pain, eye redness, patchy blind spots in your side (peripheral) or central vision, halos around the eyes and tunnel vision in the advanced stages. Treatment for this condition may focus on lowering the eye pressure (intraocular pressure) and may include – prescription eye drops (Prostaglandins, beta blockers, Alpha-adrenergic agonists), oral medications, and surgery or a combination of any of these. Surgery options include – laser therapy, drainage tubes, filtering surgery and minimally invasive glaucoma surgery (MIGS). ICD-10 codes for glaucoma diagnosis include –

H40 – Glaucoma

• H40.0 – Glaucoma suspect
• H40.1 – Open-angle glaucoma
• H40.2 – Primary angle-closure glaucoma
• H40.3 – Glaucoma secondary to eye trauma
• H40.4 – Glaucoma secondary to eye inflammation
• H40.5 – Glaucoma secondary to other eye disorders
• H40.6 – Glaucoma secondary to drugs
• H40.8 – Other glaucoma
• H40.9 – Unspecified glaucoma

H42 – Glaucoma in diseases classified elsewhere

Cataract – Even though any person can get cataract, the probability of getting affected by this condition increases 60 times if a person is diabetic, compared to non-diabetic persons. Rapid shifts in blood sugar levels may often cause the vision to become blurry in people with diabetes. This temporary blurring can diffuse into the lens of the eye and cause it to swell, thus changing the focal point of the eye, resulting in blurred vision. Over time, repeated swelling of this type is thought to damage the lens and cause it to become cloudy, resulting in a cataract. Common symptoms of this condition include- blurred vision and glared vision. Treatment for cataract mostly involves surgical removal of the clouded lens, and replacing it with a new artificial one. ICD-10 codes for Cataracts include –

H25 – Age-related cataract

• H25.0 – Age-related incipient cataract
  • H25.01 – Cortical age-related cataract
  • H25.03 – Anterior subcapsular polar age-related cataract
  • H25.04 – Posterior subcapsular polar age-related cataract
  • H25.09 – Other age-related incipient cataract
• H25.1 – Age-related nuclear cataract
• H25.2 – Age-related cataract, morgagnian type
• H25.8 – Other age-related cataract
• H25.9 – Unspecified age-related cataract

H26 – Other cataract

• H26.0 – Infantile and juvenile cataract
• H26.1 – Traumatic cataract
• H26.2 – Complicated cataract
• H26.3 – Drug-induced cataract
• H26.4 – Secondary cataract
• H26.8 – Other specified cataract
• H26.9 – Unspecified cataract

H27 – Other disorders of lens

• H27.0 – Aphakia
• H27.1 – Dislocation of lens
  • H27.10 – Unspecified dislocation of lens
  • H27.11 – Subluxation of lens
  • H27.12 – Anterior dislocation of lens
  • H27.13 – Posterior dislocation of lens
• H27.8 – Other specified disorders of lens
• H27.9 – Unspecified disorder of lens

H28 – Cataract in diseases classified elsewhere

Diabetic people are at increased risk of experiencing a variety of eye problems. It is important to have regular eye checkups and comprehensive eye exams, including dilation, every year. It is vital for patients to disclose all their symptoms to the ophthalmologist including all the medications they consume. Blurred vision can be a minor problem which can be easily prevented through eye drops or a new prescription for eyeglasses. In most cases, early treatment can correct the problem or prevent it from getting worse.

Managing diabetes or blood sugar level is one of the best ways to lower the risk of diabetes- related eye problems. That means keeping the blood sugar levels as close to normal as possible. This can be done by engaging in regular physical activity, eating healthy, and carefully following the physician’s instructions regarding insulin or other diabetes medicines.

With proper clinical documentation, coders in a reputable physician billing company can help physicians report different types of diabetes-related eye diseases using the right codes. Proper code selection is essential to maximize reimbursement and avoid denials.