ICD-10 Coding for Diabetes with Cataract(E11.36, E10.36)
Complete ICD-10-CM coding and documentation guide for Diabetes with Cataract. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetes with Cataract
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.36 | Type 2 diabetes mellitus with diabetic cataract | Use when cataract is directly linked to type 2 diabetes. |
|
| E10.36 | Type 1 diabetes mellitus with diabetic cataract | Use when cataract is directly linked to type 1 diabetes. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: How do you code diabetes with cataract?
Essential facts and insights about Diabetes with Cataract
Primary ICD-10-CM Codes for initials of a doctor with cataract
Decision Criteria
clinical Criteria
- Presence of diabetic cataract confirmed by ophthalmic examination.
documentation Criteria
- Explicit documentation linking cataract to diabetes.
Applicable To
- Diabetic cataract in type 2 diabetes
Excludes
- Cataract not related to diabetes
Clinical Validation Requirements
- HbA1c >7%
- Slit-lamp findings: posterior subcapsular opacities
Code-Specific Risks
- Incorrectly assuming all cataracts in diabetics are diabetic cataracts.
Coding Notes
- Ensure documentation specifies the linkage between diabetes and cataract.
E10.36 - Type 1 diabetes mellitus with diabetic cataract
Use when cataract is directly linked to type 1 diabetes.
Applicable To
- Diabetic cataract in type 1 diabetes
Excludes
- Cataract not related to diabetes
Clinical Validation Requirements
- HbA1c >7%
- Slit-lamp findings: posterior subcapsular opacities
Coding Notes
Ensure documentation specifies the linkage between diabetes and cataract.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diabetes with Cataract to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.36.
Impact
Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with ICD-10 guidelines., Financial: Potential for denied claims.
Mitigation Strategy
Train staff on documentation requirements., Use templates that prompt for linkage documentation.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health data.
Mitigation Strategy
Use specific combination codes like E11.36 or E10.36.
Impact
Failure to document the linkage between diabetes and cataract.
Mitigation Strategy
Implement documentation checks and training.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Diabetes with Cataract, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetes with Cataract
Use these documentation templates to ensure complete and accurate documentation for Diabetes with Cataract. These templates include all required elements for proper coding and billing.
Bilateral diabetic cataracts with type 2 DM
Specialty: OphthalmologyRequired Elements
- Type of diabetes
- Cataract type and laterality
- Linkage between diabetes and cataract
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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