Oth diab with prolif diab rtnop with trctn dtch macula, bi

This diagnosis code indicates a form of diabetes mellitus, other than type 1 or type 2, that has led to severe eye complications. Specifically, it describes the presence of new, abnormal blood vessel growth in the retina (proliferative diabetic retinopathy) which has caused the retina to pull away from its normal position, affecting the central part of vision in both eyes.

Use this code when documentation confirms a diagnosis of "other specified diabetes mellitus" (e.g., secondary diabetes due to pancreatectomy, drug-induced diabetes) and bilateral proliferative diabetic retinopathy with traction retinal detachment involving the macula. This code requires clear physician documentation of the specific type of diabetes and the detailed bilateral ocular complications.

• Ensure the diabetes type is explicitly documented as "other specified" and not Type 1 or Type 2, which have different code series.
• Verify that the documentation specifies proliferative diabetic retinopathy and traction retinal detachment, with macular involvement in both eyes.
• Always sequence the diabetes code first, followed by any associated complications, unless a specific guideline dictates otherwise.