ICD Code E11.359

ICD code E11.359 is type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema.

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

2. Evidence of proliferative diabetic retinopathy is present, as determined by ophthalmologic examination (e.g., neovascularization, vitreous hemorrhage, or preretinal hemorrhage).

3. There is no clinical or diagnostic evidence of macular edema.

4. The retinopathy is not attributable to another cause or type of diabetes.

5. The diagnosis is documented by a qualified healthcare provider.

Relevant CPT codes for ICD code E11.359 may include:

- 92250 (Fundus photography with interpretation and report)

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

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

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

- 67028 (Intravitreal injection of a pharmacologic agent)

- 92014 (Ophthalmological services, comprehensive, established patient)

- 92004 (Ophthalmological services, comprehensive, new patient)

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