Type 1 diab with prolif diab rtnop with comb detach, r eye

This code signifies a patient diagnosed with Type 1 diabetes who has developed severe diabetic retinopathy, specifically proliferative type, affecting the right eye. The retinopathy has progressed to cause a complex retinal detachment in the right eye, involving both tractional forces and a retinal break (rhegmatogenous component).

This code is appropriate when documentation clearly indicates Type 1 diabetes and a diagnosis of proliferative diabetic retinopathy in the right eye, complicated by a combined tractional and rhegmatogenous retinal detachment. The physician's notes should specify the type of diabetes, the laterality of the retinopathy, and the dual nature of the retinal detachment.

• Ensure the documentation explicitly states "Type 1 diabetes" and not "Type 2" or "unspecified."
• Verify that both "proliferative diabetic retinopathy" and "combined traction retinal detachment and rhegmatogenous retinal detachment" are clearly documented for the right eye.
• Do not use this code if only one type of retinal detachment (tractional or rhegmatogenous) is present, or if the laterality is not specified or is for the left eye.