Wiki Eye diagnosis code

[cpccoder2008]

What is the difference between 362.83 Macular Edema (CSME) and 362.07 Diabetic Macular Edema (other than one is a diabetic code) ? I know when using 362.07 you also have to use 362.02-362.06 along with 250.5* but do you always use 362.07 in a diabetic patient with macular edema ? My physician's will say IDDM & NPDR & CSME. Thanks

 

[mitchellde]

In order to code diabetic macular edema the physician must document that the diabetes is the causal condition by stating diabetic macular edema or macular edema due to diabetes.

 

[cpccoder2008]

He does not clarify. He puts DM with NPDR with CSME or he will put DM & NPDR & CSME. I code CSME as 362.83 and not 362.07 because i am not the physician and seeing the patient therefore cannot say it's caused by the diabetes. Also the code for CSME is 362.83 in my opinion if he would like it to be 362.07 he should be more specific and refer to it as diabetic macular edema. But i wanted to get clarification on this. I completly agree with you though. Thanks