Diabetes with moderate nonp rtnop with macular edema, r eye

This code signifies diabetes mellitus that is a direct consequence of another underlying disease or condition, rather than type 1 or type 2 diabetes. Specifically, it indicates the presence of moderate nonproliferative diabetic retinopathy affecting the right eye, complicated by macular edema. This stage of retinopathy involves microaneurysms, hemorrhages, and cotton wool spots, with significant fluid accumulation in the macula.

Use this code when documentation clearly states diabetes is secondary to another condition (e.g., cystic fibrosis, pancreatitis, drug-induced) and the patient presents with moderate nonproliferative diabetic retinopathy and macular edema in the right eye. The physician's notes should specify the underlying condition causing the diabetes and the laterality and severity of the retinopathy and macular edema.

• Always code the underlying condition causing the diabetes first, followed by this code.
• Ensure documentation specifies "moderate" nonproliferative retinopathy and "macular edema" in the "right eye."
• Do not use this code for type 1 or type 2 diabetes; refer to the appropriate E10 or E11 subcategories.