Diab due to undrl cond w unsp diab rtnop w/o macular edema

This code signifies diabetes that is a direct consequence of another medical condition, rather than type 1 or type 2 diabetes, and is complicated by damage to the retina of the eye. The retinopathy is not specified as to its severity or type (e.g., proliferative, nonproliferative), and there is no associated swelling in the macula.

Use this code when documentation clearly states diabetes is secondary to another condition (e.g., cystic fibrosis, pancreatectomy, drug-induced) and mentions diabetic retinopathy without specifying macular edema. This code is appropriate when the type or stage of retinopathy is not further detailed in the medical record.

• Always sequence the underlying condition causing the diabetes first, followed by this code.
• Do not use this code if the retinopathy is specified as having macular edema; a more specific code would be required.
• Query the provider for clarification on the type/stage of retinopathy and presence of macular edema if not documented, to allow for more specific coding.