Diabetes with prolif diabetic rtnop with macular edema, bi

This code signifies diabetes that is a consequence of another medical condition, specifically presenting with advanced diabetic retinopathy affecting both eyes. The retinopathy is characterized by new blood vessel growth (proliferative) and swelling in the macula, the central part of the retina responsible for sharp, detailed vision. This combination indicates severe ocular complications of secondary diabetes.

Apply this code when documentation clearly states a patient has diabetes caused by an underlying condition (e.g., cystic fibrosis, pancreatitis, drug-induced) and exhibits bilateral proliferative diabetic retinopathy with macular edema. The physician's notes must explicitly link the diabetes to the underlying condition and confirm the specific retinopathy findings in both eyes.

• Ensure the documentation specifies the underlying condition causing the diabetes; otherwise, a different diabetes code category (e.g., Type 1 or Type 2) may be more appropriate.
• Verify that both "proliferative diabetic retinopathy" and "macular edema" are present and explicitly noted as bilateral.
• Sequence the code for the underlying condition first, followed by this diabetes code, as it is a manifestation of the primary condition.