Type 1 diab w prolif diab rtnop with trctn dtch n-mcla, bi

This code signifies a severe complication of Type 1 diabetes, characterized by abnormal blood vessel growth in the retina (proliferative diabetic retinopathy) leading to scar tissue formation that pulls on the retina, causing it to detach. Specifically, the detachment affects both eyes and does not involve the central vision area (macula).

Apply this code when documentation clearly states a diagnosis of Type 1 diabetes and bilateral proliferative diabetic retinopathy with tractional retinal detachment that spares the macula. This is typically seen in patients with long-standing or poorly controlled diabetes. Supporting documentation would include ophthalmology reports detailing the retinal findings and the specific type of detachment.

• Ensure the documentation specifies "Type 1" diabetes; do not assume if only "diabetes" is mentioned.
• Verify that the retinopathy is explicitly stated as "proliferative" and the detachment as "tractional" and "not involving the macula."
• Confirm the bilateral nature of the condition; if unilateral, a different code would be appropriate.