E10.37X3 — Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
E10.37X3 is a billable, specific ICD-10-CM code for type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral. It is valid for submission on a claim.
7th character "3" — bilateral
One of the following 7th characters is to be assigned to code E10.37 to designate laterality of the disease:
- 1
- right eye
- 2
- left eye
- 3
- bilateral
- 9
- unspecified eye
Risk adjustment
E10.37X3 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 37 Diabetes with Chronic Complications0.166 RAF
- HCC 37 Diabetes with Chronic Complications0.166 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
E10.37X3 is named in 41 Medicare coverage policies — 40 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57069Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)not covered
- A52464Glucose Monitor - Policy Article
- A52501Therapeutic Shoes for Persons with Diabetes - Policy Article
- A52507External Infusion Pumps - Policy Article
Related codes at this level
Codes that share E10.37. If E10.37X3 is not quite right, the correct code is usually one of these.
- E10.37X1Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
- E10.37X2Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
- E10.37X9Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
Questions about E10.37X3
- Is E10.37X3 a billable ICD-10-CM code?
- Yes. E10.37X3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does E10.37X3 sit in the tabular list?
- Endocrine, nutritional and metabolic diseases (E00-E89), in the block Diabetes mellitus (E08-E13).