Oth diabetes with prolif diabetic rtnop with comb detach, bi

This code signifies a form of diabetes mellitus, not classified as type 1 or type 2, that has led to severe ocular complications. Specifically, it indicates the presence of proliferative diabetic retinopathy in both eyes, characterized by the growth of abnormal new blood vessels, which has further progressed to a combined tractional and rhegmatogenous retinal detachment bilaterally. This represents a complex and advanced stage of diabetic eye disease.

Apply this code when documentation clearly states "other specified diabetes mellitus" and bilateral proliferative diabetic retinopathy with both tractional and rhegmatogenous retinal detachments. This diagnosis requires detailed ophthalmological findings confirming the specific types of retinal detachment in both eyes. Use this code for patients whose diabetes type is not definitively identified as type 1 or type 2 but is explicitly documented as "other specified."

• Ensure the documentation specifies "other specified diabetes mellitus" and not simply "diabetes mellitus."
• Verify that both proliferative diabetic retinopathy and both types of retinal detachment (tractional and rhegmatogenous) are present and explicitly noted as bilateral.
• Do not use this code if only one type of retinal detachment is documented or if the condition is unilateral. Specific codes exist for those scenarios.