Type 1 diab with moderate nonp rtnop with macular edema, bi

This code signifies a diagnosis of Type 1 diabetes mellitus complicated by diabetic retinopathy that has progressed to a moderate nonproliferative stage. Crucially, it also indicates the presence of macular edema affecting both eyes, which is a significant vision-threatening complication.

Apply this code when a patient with Type 1 diabetes presents with documented moderate nonproliferative diabetic retinopathy and bilateral macular edema. Supporting documentation should include ophthalmological exam findings, such as fundus photography, optical coherence tomography (OCT) scans, and physician notes explicitly stating the severity and bilaterality of the retinopathy and macular edema.

• Ensure documentation specifies "Type 1" diabetes; do not use for Type 2 or unspecified diabetes.
• Verify that both "moderate nonproliferative" and "macular edema" are clearly documented for both eyes.
• Do not use this code if the retinopathy is proliferative or if macular edema is unilateral or absent.