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diabetic cataract

  1. Default diabetic cataract
    Medical Coding Books
    Can someone tell me for diabetic cataract type 1 & 2 do you use additional code with that and would the both be in the (H40-H42) for the additional code.
    like E10.36 TYPE 1 DIABETIC CATARACT AND E11.36 TYPE 2 DIABETIC CATARACT?
    THANK YOU

  2. #2
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    Columbia, MO
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    No you do not add a code for the cataract, it is inclusive in the diabetic code.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
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    Coding Clinic : 1991 3Q Titled Cataract:

    A true diabetic cataract or "snowflake cataract" is rare and occurs in Type I (insulin-dependent juvenile onset) diabetics. Code as 250.51, Diabetes mellitus with ophthalmic manifestations, Type I, and 366.41, Diabetic .

    Senile cataracts in persons with diabetes mellitus are not classified as ocular manifestations of the diabetes. Typical senile cataracts (366.10) occur earlier and more frequently in diabetics, but are not diabetic cataracts. Code the diabetes and the senile cataract(s) as separate entities (250.OX + 366.10).

    --- I take this to mean that it is NOT enough when a provider indicates:

    Diabetes Type II with cataract.

    It sounds like the actual words 'cataract DUE TO diabetes' are needed in order to code correctly, does anyone find this correct? Or I'm I looking for more than what I should?
    Rebecca Torres

  4. #4
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    Quote Originally Posted by MMORITZ View Post
    Can someone tell me for diabetic cataract type 1 & 2 do you use additional code with that and would the both be in the (H40-H42) for the additional code.
    like E10.36 TYPE 1 DIABETIC CATARACT AND E11.36 TYPE 2 DIABETIC CATARACT?
    THANK YOU
    Good question! One side note before I add to it... H40-H42 is Glaucoma. I'm going to assume MMORTIZ meant H25-H26 but I might be now thinking the Cataracts, Retinal Disorders and Glaucoma sections in the H chapter are all represented in E10 and E11 for our Type 1 and Type 2 Diabetics, so...

    Additional Question - ICD10's guidelines don't really touch on the subject other than to define "With" as "due to" OR "associated with". So looking at E11.36 for example, Type 2 diabetes mellitus with diabetic cataract.

    This term diabetic cataract is begging for a definition which is not included in the book.

    Does anyone have a cite that I can reference when discussing the use with our doctors? Because I'd really appreciate that.

  5. Exclamation AHA Clinic: ICD-10-CM/PCS Coding Clinic, Fourth Quarter ICD-10 2016 Pages: 142-14
    Question:

    We have previously been extensively trained that the diabetic cataract is rare, and may occur with rapid onset in Type I diabetics. Coding Clinic for ICD-9- CM previously informed us that the type of cataract more commonly found in adult diabetic patients is the age-related cataract which is not classified as an ocular manifestation of diabetes. The new "With" guidelines instruct us to link any condition indented under the word "with" to diabetes. In this guideline, all cataracts in diabetic patients are diabetic cataracts. Is there a change in understanding of the pathophysiology of the diabetic cataract, and if so, are all cataracts in diabetic patients now considered diabetic cataracts?

    Answer:

    The advice published in Coding Clinic for ICD- 9-CM for diabetic cataracts dates back to 1985. Based on the revised guideline and changes in the understanding of the relationship between diabetes and cataracts, cataracts in diabetic patients should be coded as linked conditions. Cataracts are considered a major cause of visual impairment in diabetic patients as the incidence and progression of cataract is elevated in patients with diabetes mellitus. Several clinical studies have shown that cataract development occurs more frequently and at an earlier age in diabetic compared to nondiabetic patients.

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