Diab with prolif diabetic rtnop without macular edema, r eye

This code signifies diabetes mellitus that has developed as a consequence of another underlying medical condition, rather than being Type 1 or Type 2 diabetes. The patient presents with proliferative diabetic retinopathy in the right eye, characterized by the growth of new, abnormal blood vessels on the retina, but without any associated swelling of the macula.

Use this code when documentation clearly states diabetes is secondary to another disease (e.g., cystic fibrosis, pancreatectomy, genetic defects) and specifies proliferative retinopathy in the right eye without macular edema. This code is appropriate when the underlying condition is identified and linked to the development of diabetes.

• Ensure the medical record explicitly links the diabetes to an underlying condition; otherwise, a different diabetes code (e.g., Type 1 or Type 2) may be more appropriate.
• Verify laterality (right eye) and the absence of macular edema are clearly documented. If macular edema is present, a different subcategory code is required.
• Always sequence the underlying condition causing the diabetes first, followed by this diabetes code.