Patient presents with complaints consistent with proliferative diabetic retinopathy (PDR).  Symptoms include blurred vision, floaters, and decreased visual acuity.  Ophthalmoscopic examination reveals neovascularization elsewhere (NVE), specifically noting neovascularization of the disc (NVD) and neovascularization of the iris (NVI),  confirming the diagnosis of proliferative diabetic retinopathy.  Fluorescein angiography demonstrates leakage confirming active neovascularization and areas of capillary non-perfusion.  The patient's medical history includes type 2 diabetes mellitus, managed with metformin and insulin.  Current HbA1c is 9.2%.  Given the presence of high-risk characteristics such as NVD and NVI,  the patient is at significant risk for vitreous hemorrhage and retinal detachment.  Treatment options including panretinal photocoagulation (PRP) laser therapy and anti-VEGF injection therapy (e.g., ranibizumab, aflibercept, bevacizumab) were discussed with the patient.  The risks and benefits of each treatment were explained, including potential complications such as cataract formation, decreased night vision with PRP, and endophthalmitis with intravitreal injections.  The patient elected to proceed with panretinal photocoagulation.  Follow-up appointment scheduled in four weeks to assess treatment response and monitor for any complications.  ICD-10 code E11.351, Diabetic retinopathy with proliferative diabetic retinopathy with neovascularization elsewhere, was used for this encounter.  CPT codes for the ophthalmoscopic examination, fluorescein angiography, and panretinal photocoagulation will be documented upon completion of the procedures.  Continued monitoring and management of diabetes are crucial to minimizing progression of diabetic retinopathy.