ICD Code E11.3513

ICD code E11.3513 is type 2 diabetes mellitus with proliferative diabetic retinopathy and macular edema in both eyes.

1. Patient has a confirmed diagnosis of type 2 diabetes mellitus.

2. Evidence of proliferative diabetic retinopathy is present on ophthalmologic examination.

3. Macular edema is documented in both eyes (bilateral involvement).

4. No indication of type 1 diabetes or other specific diabetes types.

5. Clinical documentation supports the coexistence of all the above conditions at the time of encounter.

Applicable CPT codes for ICD code E11.3513 may include:

- 67028 (Intravitreal injection of a pharmacologic agent)

- 67210 (Destruction of localized lesion of retina, photocoagulation)

- 67228 (Treatment of extensive or progressive retinopathy, photocoagulation)

- 92134 (Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; retina)

- 92235 (Fluorescein angiography with interpretation and report, unilateral or bilateral)

- 92240 (Indocyanine-green angiography with interpretation and report, unilateral or bilateral)

- 92083 (Visual field examination, extended)

Selection of CPT codes should be based on the specific services rendered.

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