Type 2 diab with prolif diab rtnop without mclr edema, unsp

This code signifies a patient diagnosed with type 2 diabetes who has developed proliferative diabetic retinopathy, a severe form of diabetic eye disease characterized by abnormal new blood vessel growth on the retina. Importantly, there is no associated macular edema, and the specific eye affected is not documented.

Use this code when documentation confirms type 2 diabetes and proliferative diabetic retinopathy without macular edema, but the medical record does not specify whether it affects the right, left, or both eyes. This code is appropriate when the physician explicitly states "unspecified eye" or when laterality is simply absent from the documentation.

• Always attempt to clarify laterality (right, left, bilateral) with the provider if not specified, as more specific codes exist.
• Do not use this code if macular edema is present; a different code from the E11.35 category would be more appropriate.
• Sequence this code after the primary diagnosis if the retinopathy is a complication of another condition, or as the primary diagnosis if it's the reason for the encounter.