Type 1 diab w prolif diab rtnop w trctn dtch macula, l eye

This code identifies a patient with insulin-dependent diabetes experiencing advanced ocular complications. Specifically, it indicates the presence of new, abnormal blood vessel growth in the retina (proliferative diabetic retinopathy) that has led to the retina detaching from its underlying support, with this detachment directly affecting the macula of the left eye. This condition severely impacts central vision.

Apply this code when documentation confirms Type 1 diabetes and a diagnosis of proliferative diabetic retinopathy with a tractional retinal detachment. The detachment must be explicitly stated as involving the macula and affecting the left eye. Supporting documentation includes ophthalmology reports, retinal imaging (e.g., OCT, fluorescein angiography), and physician notes detailing the specific type and location of the retinal detachment.

• Ensure the documentation specifies "tractional" retinal detachment and "involving the macula" for the left eye. Other types of detachments or locations require different codes.
• Verify laterality (left eye) is clearly documented. If both eyes are affected, separate codes for each eye or a bilateral code (if available) would be necessary.
• Do not use this code if the retinopathy is non-proliferative or if the retinal detachment is rhegmatogenous or exudative, even if diabetic in origin.