Oth diab with prolif diabetic rtnop with macular edema, unsp

This code signifies a form of diabetes mellitus, not type 1 or type 2, that has led to severe retinal damage characterized by abnormal new blood vessel growth (proliferative retinopathy) and swelling in the central part of the retina (macular edema) in an unspecified eye. This condition can severely impair vision.

Apply this code when documentation specifies "other specified diabetes mellitus" (e.g., secondary diabetes due to pancreatectomy or drug-induced) and clearly indicates the presence of proliferative diabetic retinopathy with macular edema. The eye affected is not specified in the medical record.

• Ensure the diabetes type is explicitly documented as "other specified" and not type 1, type 2, or gestational.
• Confirm both proliferative retinopathy and macular edema are present and linked to the diabetes.
• If the affected eye (right, left, or bilateral) is known, a more specific code should be used.