E08.3513 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral

ICD10CM code

#### Name of the Condition
- Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral
- ICD Code: E08.3513

#### Summary
Diabetes mellitus due to an underlying condition with proliferative diabetic retinopathy and macular edema, bilateral, is a complex condition. It involves damage to the eye's retina due to prolonged diabetes leading to the growth of abnormal blood vessels and fluid accumulation, affecting the macula in both eyes. This is a serious ophthalmic complication that can occur alongside various systemic illnesses causing diabetes.

#### Causes
- The condition is primarily caused by prolonged high blood sugar levels due to secondary diabetes from an underlying condition such as Cushing's syndrome, acromegaly, or pancreatic disease.
- These persistently high glucose levels damage the blood vessels in the retina.

#### Risk Factors
- Having an underlying disease that affects insulin production or effectiveness.
- Long-standing uncontrolled diabetes.
- High blood pressure and high cholesterol.
- Smoking and obesity increase risks.

#### Symptoms
- Blurred or distorted vision.
- Floaters or dark spots in vision.
- Difficulty seeing colors.
- Poor night vision.
- Vision loss, potentially severe if untreated.

#### Diagnosis
- Comprehensive dilated eye exams including fluorescein angiography and optical coherence tomography (OCT).
- Blood tests to assess glucose levels such as HbA1c.

#### Treatment Options
- Anti-VEGF injections to decrease abnormal blood vessels growth.
- Laser therapy to seal leaking blood vessels.
- Corticosteroid injections or implants in the eye.
- Vitrectomy surgery if bleeding is severe.
- Tight control of blood sugar, blood pressure, and cholesterol.

#### Prognosis and Follow-Up
- Regular ophthalmic evaluations are critical.
- Visual outcomes are highly variable; early detection and treatment are essential to prevent vision loss.
- Life-long management of the underlying diabetes or systemic condition is crucial to minimize progression.

#### Complications
- If left untreated, it can progress to severe vision loss or even blindness.
- Risk of retinal detachment.
- Development of glaucoma or cataracts.

#### Lifestyle & Prevention
- Strict control of blood sugar levels through diet, exercise, and medication.
- Regular monitoring of blood pressure and cholesterol.
- Cessation of smoking and limiting alcohol intake.
- Use of protective eyewear to prevent eye injuries.

#### When to Seek Professional Help
- Suddenly experiencing any change in vision.
- Seeing flashes of light or sudden increase in floaters.
- Persistent eye pain or redness.

#### Additional Resources
- American Diabetes Association (ADA)
- National Eye Institute (NEI)
- Diabetic Retina Network

#### Tips for Medical Coders
- Ensure documentation specifies the link between the underlying condition, diabetes, and retinopathy.
- Confirm bilateral involvement in coding.
- Watch for the specific mention of macular edema in both eyes.

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