Schedule your diabetic eye exam, also known as a diabetic retinal exam or diabetic ophthalmic examination, today. Early detection of diabetic retinopathy is crucial for preserving vision. Find information on diabetic eye exam frequency, clinical documentation requirements for medical coding, and healthcare coverage for this essential preventative care. Learn about the importance of annual diabetic eye screenings and comprehensive eye health for patients with diabetes.
Also known as
Diabetes mellitus
Codes for various types of diabetes and related complications.
Disorders of lens
Includes cataracts, a common diabetic eye complication.
Disorders of choroid and retina
Covers diabetic retinopathy and other retinal disorders.
Visual disturbances
Includes blurred vision, a symptom of diabetic eye problems.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is exam for screening/monitoring of diabetic retinopathy?
Yes
Any diabetic retinopathy findings?
No
Is exam for other diabetic eye complications?
When to use each related code
| Description |
|---|
| Exam to detect diabetic eye disease. |
| General eye exam, not specific to diabetes. |
| Exam for proliferative diabetic retinopathy. |
Coding requires specifying type of diabetes (Type 1, Type 2, etc.) for accurate reimbursement and quality reporting.
Missing laterality (right, left, both) can lead to claim denials and inaccurate data for diabetic retinopathy tracking.
Insufficient documentation supporting the medical necessity of the exam can trigger audits and claim rejection.
Q: What are the key differences in diabetic retinopathy screening guidelines between type 1 and type 2 diabetes for optimal patient management?
A: While both type 1 and type 2 diabetes necessitate regular diabetic eye exams to detect and manage diabetic retinopathy, screening guidelines vary slightly based on disease onset and progression. For type 1 diabetes, the American Diabetes Association recommends a comprehensive dilated eye exam within 5 years of diagnosis and annually thereafter. In type 2 diabetes, screening should commence at diagnosis and then annually. However, more frequent examinations may be necessary in both types if retinopathy is detected or progresses. Consider implementing a risk-stratified approach based on individual patient factors such as glycemic control, blood pressure, and duration of diabetes for optimal patient management. Explore how our platform can assist in streamlining patient scheduling and integrating these guidelines into your practice.
Q: How can I effectively communicate the importance of regular diabetic eye exams to non-compliant patients, especially those with asymptomatic early-stage diabetic retinopathy?
A: Communicating the importance of regular diabetic eye exams to non-compliant patients, particularly those asymptomatic with early-stage diabetic retinopathy, requires a clear and empathetic approach. Emphasize that diabetic retinopathy is often asymptomatic in its initial stages, meaning patients may not experience vision changes until the disease has significantly progressed. Explain that early detection through a dilated eye exam allows for timely interventions that can prevent or delay vision loss. Using visual aids like retinal images can further illustrate the potential impact of the disease. Address any patient concerns regarding the exam process itself, highlighting its non-invasive nature. Consider implementing patient education materials that reinforce the link between diabetes management and eye health. Learn more about effective communication strategies for improving patient adherence to diabetic eye exam schedules.
Patient presented for a diabetic eye exam, also known as a diabetic retinal exam or diabetic ophthalmic examination, due to a diagnosis of type 2 diabetes mellitus. The patient reported no specific visual complaints at this time. Medical history includes well-controlled diabetes with metformin, hypertension managed with lisinopril, and hyperlipidemia treated with atorvastatin. Ocular history is significant for presbyopia corrected with reading glasses. Visual acuity was 20/20 in both eyes with correction. Intraocular pressure was measured at 14 mmHg in the right eye and 16 mmHg in the left eye. Dilated fundus examination revealed no evidence of diabetic retinopathy, macular edema, or neovascularization. The optic discs appeared healthy with sharp margins. Assessment: No diabetic retinopathy detected. Plan: Educated the patient on the importance of regular diabetic eye exams for early detection and prevention of diabetic eye disease complications, including proliferative diabetic retinopathy, diabetic macular edema, and vision loss. Recommended annual follow-up diabetic retinal screening given the current absence of retinopathy. Patient verbalized understanding of the plan and the importance of glycemic control in mitigating the risk of diabetic eye disease progression. ICD-10 code Z13.1 for encounter for screening for diabetic retinopathy was documented. CPT code 92250 for ophthalmoscopy with dilation was billed.