Type 1 diab with prolif diab rtnop with macular edema, unsp

This code signifies a patient diagnosed with Type 1 diabetes who has developed proliferative diabetic retinopathy, a severe form of retinal damage characterized by new, fragile blood vessel growth. This retinopathy is further complicated by macular edema, swelling in the central part of the retina responsible for sharp, detailed vision, affecting an unspecified eye.

Use this code when documentation clearly states Type 1 diabetes and confirms the presence of proliferative diabetic retinopathy with associated macular edema. This is appropriate for patients undergoing treatment or monitoring for these specific diabetic complications. Physician notes should explicitly mention both the retinopathy stage and the macular involvement.

• Ensure the documentation specifies "Type 1" diabetes; do not use for Type 2 or unspecified diabetes.
• Verify that both "proliferative diabetic retinopathy" and "macular edema" are explicitly stated, not just implied.
• This code is for an unspecified eye; if the laterality (right or left) is documented, a more specific code should be chosen.