E09.3499

E09.3499: Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye

Billable / specific codeICD-10-CM

E09.3499 is a billable, specific ICD-10-CM code for drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye. It is valid for submission on a claim.

Check E09.3499 with the rest of the claim: free scrubber

7th character "9": unspecified eye

One of the following 7th characters is to be assigned to codes in subcategory E09.34 to designate laterality of the disease:

1: right eye
2: left eye
3: bilateral
9: unspecified eye

Excludes1 inherited from the categories above E09.3499

A category’s note binds every code beneath it.

Written on E09: Drug or chemical induced diabetes mellitus

diabetes mellitus due to underlying condition (E08.-)
gestational diabetes (O24.4-)
neonatal diabetes mellitus (P70.2)
postpancreatectomy diabetes mellitus (E13.-)
postprocedural diabetes mellitus (E13.-)
secondary diabetes mellitus NEC (E13.-)
type 1 diabetes mellitus (E10.-)
type 2 diabetes mellitus (E11.-)

Other codes that can never be billed with E09.3499

Their own Excludes1 notes name this code, so the conflict is not listed above.

E08Diabetes mellitus due to underlying condition
E10Type 1 diabetes mellitus
E11Type 2 diabetes mellitus
E13Other specified diabetes mellitus

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

E09.3499 is named in 7 Medicare coverage policies: 7 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52464Glucose Monitor - Policy Article
A52501Therapeutic Shoes for Persons with Diabetes - Policy Article
A52507External Infusion Pumps - Policy Article
A56232Billing and Coding: Foot Care

Code history

Unchanged in every release from FY2024 to FY2027.