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Telehealth Updates - 2022

Telehealth

The telemedicine will be providing to improve a patient's health by permitting two-way, real time interactive audio and video communication between into the patients, and the physician or practitioner at the distant site.

Requirements

  • Two way real time interactive audio and video communication must be documented in the medical record.
  • Type of communication -Used devices.
  • Patient Location and Provider Location.

Place of Services (POS) Changes

  • Effective Date - January 1, 2022
  • Implementation Date - April 4, 2022

The place of service can be used to specify the setting information necessary to pay the claims correctly. And new place of service introduced place of service (POS 10), revised the description of POS code 02 to meet the overall industry needs.

POS 02 - Telehealth Provided Other than in "Patient’s Home"

Description: The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in their home when receiving health services or health related services through telecommunication technology.

POS 10: Telehealth Provided in "Patient’s Home"

Description: The location where health services and health related services are provided or received through telecommunication technology. Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.

Insurance Updates

Beginning Jan. 1, Anthem and UnitedHealthcare (UHC) will require commercial and Medicare Advantage plans to use new place of service (POS) 10 for telehealth provided in the patient’s home. 

Place of service 02 should continue to be used when telehealth is provided anywhere other than a patient’s home (e.g., a hospital or skilled nursing facility). 

Mental Health Services

Reimbursement for audio-only services for mental health will continue after the public health emergency ends.

Following changes made through new federal legislation, CMS will allow audio-only services to be provided for the diagnosis, evaluation, and treatment of mental health conditions and substance use disorders after the public health emergency (PHE) ends. 

Telehealth Extended Date

UnitedHealthcare will extend the expansion of telehealth access for in-network and out-of-network providers through the national public health emergency period, currently scheduled to end April 15, 2022.

The Centers for Medicare & Medicaid Services (CMS) proposed in the 2022 Physician Fee Schedule to extend telehealth flexibilities through 2023 instead of through the end of the COVID-19 public health emergency, which is expected to run through this year.

APA supported CMS’s proposal allowing all psychological and neuropsychological testing services to be provided via telehealth after the PHE ends. 

The CMS adopted this proposal, keeping psychological and neuropsychological testing on the temporary (category 3) telehealth list through the end of 2023.

Info: Medicare does not identified a need for new place of service code 10. And the MACs will instruct their providers to continue to use the Medicare billing instructions for Telehealth claims.


Telehealth Codes

Glaucoma Screening

 HCPCS/CPT Codes

  • G0117 – Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist
  • G0118 – Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist

ICD-10 Codes

B73.02 Onchocerciasis with glaucoma
H26.231 Glaucomatous flecks (subcapsular), right eye
H26.232 Glaucomatous flecks (subcapsular), left eye
H26.233 Glaucomatous flecks (subcapsular), bilateral
H26.239 Glaucomatous flecks (subcapsular), unspecified eye
H40.001 Preglaucoma, unspecified, right eye
H40.002 Preglaucoma, unspecified, left eye
H40.003 Preglaucoma, unspecified, bilateral
H40.009 Preglaucoma, unspecified, unspecified eye
H40.061 Primary angle closure without glaucoma damage, right eye
H40.062 Primary angle closure without glaucoma damage, left eye
H40.063 Primary angle closure without glaucoma damage, bilateral
H40.069 Primary angle closure without glaucoma damage, unspecified eye
H40.10X0 Unspecified open-angle glaucoma, stage unspecified
H40.10X1 Unspecified open-angle glaucoma, mild stage
H40.10X2 Unspecified open-angle glaucoma, moderate stage
H40.10X3 Unspecified open-angle glaucoma, severe stage
H40.10X4 Unspecified open-angle glaucoma, indeterminate stage
H40.1110 Primary open-angle glaucoma, right eye, stage unspecified
H40.1111 Primary open-angle glaucoma, right eye, mild stage
H40.1112 Primary open-angle glaucoma, right eye, moderate stage
H40.1113 Primary open-angle glaucoma, right eye, severe stage
H40.1114 Primary open-angle glaucoma, right eye, indeterminate stage
H40.1120 Primary open-angle glaucoma, left eye, stage unspecified
H40.1121 Primary open-angle glaucoma, left eye, mild stage
H40.1122 Primary open-angle glaucoma, left eye, moderate stage
H40.1123 Primary open-angle glaucoma, left eye, severe stage
H40.1124 Primary open-angle glaucoma, left eye, indeterminate stage
H40.1130 Primary open-angle glaucoma, bilateral, stage unspecified
H40.1131 Primary open-angle glaucoma, bilateral, mild stage
H40.1132 Primary open-angle glaucoma, bilateral, moderate stage
H40.1133 Primary open-angle glaucoma, bilateral, severe stage
H40.1134 Primary open-angle glaucoma, bilateral, indeterminate stage
H40.1190 Primary open-angle glaucoma, unspecified eye, stage unspecified
H40.1191 Primary open-angle glaucoma, unspecified eye, mild stage
H40.1192 Primary open-angle glaucoma, unspecified eye, moderate stage
H40.1193 Primary open-angle glaucoma, unspecified eye, severe stage
H40.1194 Primary open-angle glaucoma, unspecified eye, indeterminate stage
H40.1210 Low-tension glaucoma, right eye, stage unspecified
H40.1211 Low-tension glaucoma, right eye, mild stage
H40.1212 Low-tension glaucoma, right eye, moderate stage
H40.1213 Low-tension glaucoma, right eye, severe stage
H40.1214 Low-tension glaucoma, right eye, indeterminate stage
H40.1220 Low-tension glaucoma, left eye, stage unspecified
H40.1221 Low-tension glaucoma, left eye, mild stage
H40.1222 Low-tension glaucoma, left eye, moderate stage
H40.1223 Low-tension glaucoma, left eye, severe stage
H40.1224 Low-tension glaucoma, left eye, indeterminate stage
H40.1230 Low-tension glaucoma, bilateral, stage unspecified
H40.1231 Low-tension glaucoma, bilateral, mild stage
H40.1232 Low-tension glaucoma, bilateral, moderate stage
H40.1233 Low-tension glaucoma, bilateral, severe stage
H40.1234 Low-tension glaucoma, bilateral, indeterminate stage
H40.1290 Low-tension glaucoma, unspecified eye, stage unspecified
H40.1291 Low-tension glaucoma, unspecified eye, mild stage
H40.1292 Low-tension glaucoma, unspecified eye, moderate stage
H40.1293 Low-tension glaucoma, unspecified eye, severe stage
H40.1294 Low-tension glaucoma, unspecified eye, indeterminate stage
H40.1310 Pigmentary glaucoma, right eye, stage unspecified
H40.1311 Pigmentary glaucoma, right eye, mild stage
H40.1312 Pigmentary glaucoma, right eye, moderate stage
H40.1313 Pigmentary glaucoma, right eye, severe stage
H40.1314 Pigmentary glaucoma, right eye, indeterminate stage
H40.1320 Pigmentary glaucoma, left eye, stage unspecified
H40.1321 Pigmentary glaucoma, left eye, mild stage
H40.1322 Pigmentary glaucoma, left eye, moderate stage
H40.1323 Pigmentary glaucoma, left eye, severe stage
H40.1324 Pigmentary glaucoma, left eye, indeterminate stage
H40.1330 Pigmentary glaucoma, bilateral, stage unspecified
H40.1331 Pigmentary glaucoma, bilateral, mild stage
H40.1332 Pigmentary glaucoma, bilateral, moderate stage
H40.1333 Pigmentary glaucoma, bilateral, severe stage
H40.1334 Pigmentary glaucoma, bilateral, indeterminate stage
H40.1390 Pigmentary glaucoma, unspecified eye, stage unspecified
H40.1391 Pigmentary glaucoma, unspecified eye, mild stage
H40.1392 Pigmentary glaucoma, unspecified eye, moderate stage
H40.1393 Pigmentary glaucoma, unspecified eye, severe stage
H40.1394 Pigmentary glaucoma, unspecified eye, indeterminate stage
H40.1410 Capsular glaucoma with pseudoexfoliation of lens, right eye, stage unspecified
H40.1411 Capsular glaucoma with pseudoexfoliation of lens, right eye, mild stage
H40.1412 Capsular glaucoma with pseudoexfoliation of lens, right eye, moderate stage
H40.1413 Capsular glaucoma with pseudoexfoliation of lens, right eye, severe stage
H40.1414 Capsular glaucoma with pseudoexfoliation of lens, right eye, indeterminate stage
H40.1420 Capsular glaucoma with pseudoexfoliation of lens, left eye, stage unspecified
H40.1421 Capsular glaucoma with pseudoexfoliation of lens, left eye, mild stage
H40.1422 Capsular glaucoma with pseudoexfoliation of lens, left eye, moderate stage
H40.1423 Capsular glaucoma with pseudoexfoliation of lens, left eye, severe stage
H40.1424 Capsular glaucoma with pseudoexfoliation of lens, left eye, indeterminate stage
H40.1430 Capsular glaucoma with pseudoexfoliation of lens, bilateral, stage unspecified
H40.1431 Capsular glaucoma with pseudoexfoliation of lens, bilateral, mild stage
H40.1432 Capsular glaucoma with pseudoexfoliation of lens, bilateral, moderate stage
H40.1433 Capsular glaucoma with pseudoexfoliation of lens, bilateral, severe stage
H40.1434 Capsular glaucoma with pseudoexfoliation of lens, bilateral, indeterminate stage
H40.1490 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, stage unspecified
H40.1491 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, mild stage
H40.1492 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, moderate stage
H40.1493 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, severe stage
H40.1494 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, indeterminate stage
H40.151 Residual stage of open-angle glaucoma, right eye
H40.152 Residual stage of open-angle glaucoma, left eye
H40.153 Residual stage of open-angle glaucoma, bilateral
H40.159 Residual stage of open-angle glaucoma, unspecified eye
H40.20X0 Unspecified primary angle-closure glaucoma, stage unspecified
H40.20X1 Unspecified primary angle-closure glaucoma, mild stage
H40.20X2 Unspecified primary angle-closure glaucoma, moderate stage
H40.20X3 Unspecified primary angle-closure glaucoma, severe stage
H40.20X4 Unspecified primary angle-closure glaucoma, indeterminate stage
H40.211 Acute angle-closure glaucoma, right eye
H40.212 Acute angle-closure glaucoma, left eye
H40.213 Acute angle-closure glaucoma, bilateral
H40.219 Acute angle-closure glaucoma, unspecified eye
H40.2210 Chronic angle-closure glaucoma, right eye, stage unspecified
H40.2211 Chronic angle-closure glaucoma, right eye, mild stage
H40.2212 Chronic angle-closure glaucoma, right eye, moderate stage
H40.2213 Chronic angle-closure glaucoma, right eye, severe stage
H40.2214 Chronic angle-closure glaucoma, right eye, indeterminate stage
H40.2220 Chronic angle-closure glaucoma, left eye, stage unspecified
H40.2221 Chronic angle-closure glaucoma, left eye, mild stage
H40.2222 Chronic angle-closure glaucoma, left eye, moderate stage
H40.2223 Chronic angle-closure glaucoma, left eye, severe stage
H40.2224 Chronic angle-closure glaucoma, left eye, indeterminate stage
H40.2230 Chronic angle-closure glaucoma, bilateral, stage unspecified
H40.2231 Chronic angle-closure glaucoma, bilateral, mild stage
H40.2232 Chronic angle-closure glaucoma, bilateral, moderate stage
H40.2233 Chronic angle-closure glaucoma, bilateral, severe stage
H40.2234 Chronic angle-closure glaucoma, bilateral, indeterminate stage
H40.2290 Chronic angle-closure glaucoma, unspecified eye, stage unspecified
H40.2291 Chronic angle-closure glaucoma, unspecified eye, mild stage
H40.2292 Chronic angle-closure glaucoma, unspecified eye, moderate stage
H40.2293 Chronic angle-closure glaucoma, unspecified eye, severe stage
H40.2294 Chronic angle-closure glaucoma, unspecified eye, indeterminate stage
H40.231 Intermittent angle-closure glaucoma, right eye
H40.232 Intermittent angle-closure glaucoma, left eye
H40.233 Intermittent angle-closure glaucoma, bilateral
H40.239 Intermittent angle-closure glaucoma, unspecified eye
H40.241 Residual stage of angle-closure glaucoma, right eye
H40.242 Residual stage of angle-closure glaucoma, left eye
H40.243 Residual stage of angle-closure glaucoma, bilateral
H40.249 Residual stage of angle-closure glaucoma, unspecified eye
H40.30X0 Glaucoma secondary to eye trauma, unspecified eye, stage unspecified
H40.30X1 Glaucoma secondary to eye trauma, unspecified eye, mild stage
H40.30X2 Glaucoma secondary to eye trauma, unspecified eye, moderate stage
H40.30X3 Glaucoma secondary to eye trauma, unspecified eye, severe stage
H40.30X4 Glaucoma secondary to eye trauma, unspecified eye, indeterminate stage
H40.31X0 Glaucoma secondary to eye trauma, right eye, stage unspecified
H40.31X1 Glaucoma secondary to eye trauma, right eye, mild stage
H40.31X2 Glaucoma secondary to eye trauma, right eye, moderate stage
H40.31X3 Glaucoma secondary to eye trauma, right eye, severe stage
H40.31X4 Glaucoma secondary to eye trauma, right eye, indeterminate stage
H40.32X0 Glaucoma secondary to eye trauma, left eye, stage unspecified
H40.32X1 Glaucoma secondary to eye trauma, left eye, mild stage
H40.32X2 Glaucoma secondary to eye trauma, left eye, moderate stage
H40.32X3 Glaucoma secondary to eye trauma, left eye, severe stage
H40.32X4 Glaucoma secondary to eye trauma, left eye, indeterminate stage
H40.33X0 Glaucoma secondary to eye trauma, bilateral, stage unspecified
H40.33X1 Glaucoma secondary to eye trauma, bilateral, mild stage
H40.33X2 Glaucoma secondary to eye trauma, bilateral, moderate stage
H40.33X3 Glaucoma secondary to eye trauma, bilateral, severe stage
H40.33X4 Glaucoma secondary to eye trauma, bilateral, indeterminate stage
H40.40X0 Glaucoma secondary to eye inflammation, unspecified eye, stage unspecified
H40.40X1 Glaucoma secondary to eye inflammation, unspecified eye, mild stage
H40.40X2 Glaucoma secondary to eye inflammation, unspecified eye, moderate stage
H40.40X3 Glaucoma secondary to eye inflammation, unspecified eye, severe stage
H40.40X4 Glaucoma secondary to eye inflammation, unspecified eye, indeterminate stage
H40.41X0 Glaucoma secondary to eye inflammation, right eye, stage unspecified
H40.41X1 Glaucoma secondary to eye inflammation, right eye, mild stage
H40.41X2 Glaucoma secondary to eye inflammation, right eye, moderate stage
H40.41X3 Glaucoma secondary to eye inflammation, right eye, severe stage
H40.41X4 Glaucoma secondary to eye inflammation, right eye, indeterminate stage
H40.42X0 Glaucoma secondary to eye inflammation, left eye, stage unspecified
H40.42X1 Glaucoma secondary to eye inflammation, left eye, mild stage
H40.42X2 Glaucoma secondary to eye inflammation, left eye, moderate stage
H40.42X3 Glaucoma secondary to eye inflammation, left eye, severe stage
H40.42X4 Glaucoma secondary to eye inflammation, left eye, indeterminate stage
H40.43X0 Glaucoma secondary to eye inflammation, bilateral, stage unspecified
H40.43X1 Glaucoma secondary to eye inflammation, bilateral, mild stage
H40.43X2 Glaucoma secondary to eye inflammation, bilateral, moderate stage
H40.43X3 Glaucoma secondary to eye inflammation, bilateral, severe stage
H40.43X4 Glaucoma secondary to eye inflammation, bilateral, indeterminate stage
H40.50X0 Glaucoma secondary to other eye disorders, unspecified eye, stage unspecified
H40.50X1 Glaucoma secondary to other eye disorders, unspecified eye, mild stage
H40.50X2 Glaucoma secondary to other eye disorders, unspecified eye, moderate stage
H40.50X3 Glaucoma secondary to other eye disorders, unspecified eye, severe stage
H40.50X4 Glaucoma secondary to other eye disorders, unspecified eye, indeterminate stage
H40.51X0 Glaucoma secondary to other eye disorders, right eye, stage unspecified
H40.51X1 Glaucoma secondary to other eye disorders, right eye, mild stage
H40.51X2 Glaucoma secondary to other eye disorders, right eye, moderate stage
H40.51X3 Glaucoma secondary to other eye disorders, right eye, severe stage
H40.51X4 Glaucoma secondary to other eye disorders, right eye, indeterminate stage
H40.52X0 Glaucoma secondary to other eye disorders, left eye, stage unspecified
H40.52X1 Glaucoma secondary to other eye disorders, left eye, mild stage
H40.52X2 Glaucoma secondary to other eye disorders, left eye, moderate stage
H40.52X3 Glaucoma secondary to other eye disorders, left eye, severe stage
H40.52X4 Glaucoma secondary to other eye disorders, left eye, indeterminate stage
H40.53X0 Glaucoma secondary to other eye disorders, bilateral, stage unspecified
H40.53X1 Glaucoma secondary to other eye disorders, bilateral, mild stage
H40.53X2 Glaucoma secondary to other eye disorders, bilateral, moderate stage
H40.53X3 Glaucoma secondary to other eye disorders, bilateral, severe stage
H40.53X4 Glaucoma secondary to other eye disorders, bilateral, indeterminate stage
H40.60X0 Glaucoma secondary to drugs, unspecified eye, stage unspecified
H40.60X1 Glaucoma secondary to drugs, unspecified eye, mild stage
H40.60X2 Glaucoma secondary to drugs, unspecified eye, moderate stage
H40.60X3 Glaucoma secondary to drugs, unspecified eye, severe stage
H40.60X4 Glaucoma secondary to drugs, unspecified eye, indeterminate stage
H40.61X0 Glaucoma secondary to drugs, right eye, stage unspecified
H40.61X1 Glaucoma secondary to drugs, right eye, mild stage
H40.61X2 Glaucoma secondary to drugs, right eye, moderate stage
H40.61X3 Glaucoma secondary to drugs, right eye, severe stage
H40.61X4 Glaucoma secondary to drugs, right eye, indeterminate stage
H40.62X0 Glaucoma secondary to drugs, left eye, stage unspecified
H40.62X1 Glaucoma secondary to drugs, left eye, mild stage
H40.62X2 Glaucoma secondary to drugs, left eye, moderate stage
H40.62X3 Glaucoma secondary to drugs, left eye, severe stage
H40.62X4 Glaucoma secondary to drugs, left eye, indeterminate stage
H40.63X0 Glaucoma secondary to drugs, bilateral, stage unspecified
H40.63X1 Glaucoma secondary to drugs, bilateral, mild stage
H40.63X2 Glaucoma secondary to drugs, bilateral, moderate stage
H40.63X3 Glaucoma secondary to drugs, bilateral, severe stage
H40.63X4 Glaucoma secondary to drugs, bilateral, indeterminate stage
H40.811 Glaucoma with increased episcleral venous pressure, right eye
H40.812 Glaucoma with increased episcleral venous pressure, left eye
H40.813 Glaucoma with increased episcleral venous pressure, bilateral
H40.819 Glaucoma with increased episcleral venous pressure, unspecified eye
H40.821 Hypersecretion glaucoma, right eye
H40.822 Hypersecretion glaucoma, left eye
H40.823 Hypersecretion glaucoma, bilateral
H40.829 Hypersecretion glaucoma, unspecified eye
H40.89 Other specified glaucoma
H40.9 Unspecified glaucoma
H42 Glaucoma in diseases classified elsewhere
H44.511 Absolute glaucoma, right eye
H44.512 Absolute glaucoma, left eye
H44.513 Absolute glaucoma, bilateral
H44.519 Absolute glaucoma, unspecified eye
H47.231 Glaucomatous optic atrophy, right eye
H47.232 Glaucomatous optic atrophy, left eye
H47.233 Glaucomatous optic atrophy, bilateral
H47.239 Glaucomatous optic atrophy, unspecified eye
Q15.0 Congenital glaucoma
Z01.020 Encounter for examination of eyes and vision following failed vision screening without abnormal findings
Z01.021 Encounter for examination of eyes and vision following failed vision screening with abnormal findings
Z71.84 Encounter for health counseling related to travel
Z83.511 Family history of glaucoma
Z98.83 Filtering (vitreous) bleb after glaucoma surgery status

Who Is Covered

Medicare beneficiaries who fall into at least one of the following categories:

  • Have diabetes mellitus
  • Have a family history of glaucoma
  • Are African-Americans aged 50 and older
  • Are Hispanic-Americans aged 65 and older

Frequency

  • Annually for covered Medicare beneficiaries

Medicare Beneficiary Pays

  • Copayment/coinsurance applies
  • Deductible applies

Facet Joint Injection

The qualified healthcare providers injects a diagnostic or therapeutic agent into a facet joints to treat the spinal pain or to identify the exact source of pain with using of imaging guidance of either fluoroscopy or CT scan. 

The joints are connecting into two spinal vertebrae together as following, 

  • Cervical Level
  • Thoracic Level. 

All of the spine, at each level, a pair of small facet joints connects the vertebrae, the bony building blocks of the spine holding the vertebral column together and providing support. 

These small joints may become inflamed due to a variety of conditions including osteoarthritis, disc degeneration, spinal stenosis, or from trauma such as a car accident.

When the facet joints become swollen and enlarged because of injury or arthritis, it causes pain, 

  • If the affected joint is in the neck, it may cause headaches and difficulty moving the head. 
  • If it is in the back, it may cause pain in the lower back, buttocks, or legs.

In cases where conservative approaches, such as anti-inflammatory medications, chiropractic manipulation, and physical therapy, don’t provide sufficient relief, denervation or injection into or around the facet joint may help relief the pain

For this service, the provider preps and anesthetizes the patient for a facet joint injection. The provider then inserts the needle through the skin, and he advances it to the proper position within the joint using either fluoroscopy or CT imaging guidance. He then injects the therapeutic or diagnostic agent, like a steroid or anesthetic mixture. He then removes the needle and ensures that the site obtains hemostasis.

  • Computed tomography, or CT, is when the provider rotates an X–ray tube and X–ray detectors around a patient, which produces a tomogram, a computer generated cross sectional image; providers use CT to diagnose, manage, and treat diseases.
  • Fluoroscopy is a live X–ray where the X–ray image appears on a fluorescent screen television monitor; providers often use fluoroscopy to view body structures while performing procedures.

Do not separately code for multiple injections at the same spinal level and do not bill imaging guidance, specifically fluoroscopy or CT.

A paravertebral facet joint represents the articulation of the posterior elements of one vertebra with its neighboring vertebrae. The facet joint is noted at a specific level by the vertebrae that form it (e.g., C4-5 or L2-3). There are two facet joints at each level, left and right, and there are 28 levels of facet joints.

Each facet joint is supplied by the medial branches of two different spinal nerves. Two to three medial branch nerves innervate each lumbar facet joint, and two nerves innervate each cervical and thoracic facet joint. These nerves are branches of the posterior division of the spinal nerves, located immediately above and below the joint.

For example, innervation of the facet joints at L4-L5 is supplied by medial branches originating from the L3 and L4 spinal nerves. As such, the physician must block two median nerves for each facet joint. In the case of a medial branch nerve block at L4-L5, the physician would inject the medial branches of L3 and L4. For coding purposes, these two injections are considered a single injection service.

CPT Codes

64490 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level

+64491 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level (List separately in addition to code for primary procedure)

+64492 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any additional level(s) (List separately in addition to code for primary procedure)

64493 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level

+64494 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to code for primary procedure)

+64495 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any additional level(s) (List separately in addition to code for primary procedure)

64633 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint

+64634 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code for primary procedure)

64635 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint

+64636 Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure)

Tips

  • Codes 64490-64495 are unilateral procedures.
  • Use CPT codes 64490 and 64493 to report all of the nerves that innervate the first level paravertebral facet joint and not each nerve.
  • Use CPT add-on codes 64491, 64492 and 64494, 64495 to report second and third additional levels of paravertebral facet joints and not each additional nerve. Facet joint levels refer to the joints that are blocked and not the number of medial branches that innervate them.
  • Report 64490-64495 once per level, irrespective of the number of drugs injected or whether single or multiple punctures are required to anesthetize the target joint at a given level and side.
  • Append modifier KX Requirements specified in the medical policy have been met to the line for all diagnostic injections.
  • Append the bilateral modifier 50 to the appropriate code when the provider performs bilateral injections/denervations.
  • Do not append multiple procedures modifier 51 to +64491, +64492, +64494, or +64495 because these are add-on codes and exempt from multiple procedure concept.
  • When your provider performs injections on both sides of one vertebral level, report the base injection code (64490 or 64493) with modifier 50 Bilateral procedure. If the physician injects a second level bilaterally, report the add-on code (+64491 or +64494), also with modifier 50.

OIG Audits - Improper Payments

Recently released audit findings from the Department of Health and Human Services (HHS) Office of Inspector General (OIG) and show that Medicare did not pay physicians for selected facet-joint denervation sessions in accordance with Medicare requirements. Due to inadequate oversight, the Centers for Medicare & Medicaid Services (CMS) improperly paid physicians a total of $9.5 million for certain facet-joint denervation sessions. Based on OIG recommendations, CMS plans as following

  • Direct the Medicare Administrative Contractors (MACs) to recover $9,528,296 in improper payments made to physicians for selected facet-joint denervation sessions.
  • Instruct the MACs to notify the physicians who received potential overpayments so they can exercise reasonable diligence to identify, report, and return any overpayments per the 60-day rule,
  • Assess the effectiveness of oversight mechanisms specific to detecting or preventing improper payments to physicians for facet-joint denervation sessions and modify the oversight mechanisms based on that assessment; and,
  • Direct the MACs to review claims for denervation sessions after the OIG’s audit period (dates of service from January 2019 through August 2020) to recover any improper payments.

This highlights the importance of verifying with your MAC the limitations of coverage's to avoid inappropriate billing for and overuse of spinal facet-joint denervation for pain management.

Source: OIG Audit

Diabetes Self-Management Training CPT G0108 and G0109

 HCPCS/CPT Codes

  • G0108 – DSMT, individual, per 30 minutes
  • G0109 – DSMT, group (2 or more), per 30 minutes

Who Is Covered

Certain Medicare beneficiaries when all of the following are true:

  • Diagnosed with diabetes
  • Receive an order for DSMT from the physician or qualified NPP treating the Medicare beneficiary’s diabetes

Frequently Used ICD Codes

  • E24.4 Alcohol-induced pseudo-Cushing's syndrome
  • F10.10 Alcohol abuse, uncomplicated
  • F10.120 Alcohol abuse with intoxication, uncomplicated
  • F10.121 Alcohol abuse with intoxication delirium
  • F10.129 Alcohol abuse with intoxication, unspecified
  • F10.14 Alcohol abuse with alcohol-induced mood disorder
  • F10.150 Alcohol abuse with alcohol-induced psychotic disorder with delusions
  • F10.151 Alcohol abuse with alcohol-induced psychotic disorder with hallucinations
  • F10.159 Alcohol abuse with alcohol-induced psychotic disorder, unspecified
  • F10.180 Alcohol abuse with alcohol-induced anxiety disorder
  • F10.181 Alcohol abuse with alcohol-induced sexual dysfunction
  • F10.182 Alcohol abuse with alcohol-induced sleep disorder
  • F10.188 Alcohol abuse with other alcohol-induced disorder
  • F10.19 Alcohol abuse with unspecified alcohol-induced disorder
  • F10.20 Alcohol dependence, uncomplicated
  • F10.21 Alcohol dependence, in remission
  • F10.220 Alcohol dependence with intoxication, uncomplicated
  • F10.221 Alcohol dependence with intoxication delirium
  • F10.229 Alcohol dependence with intoxication, unspecified
  • F10.230 Alcohol dependence with withdrawal, uncomplicated
  • F10.231 Alcohol dependence with withdrawal delirium
  • F10.232 Alcohol dependence with withdrawal with perceptual disturbance
  • F10.239 Alcohol dependence with withdrawal, unspecified
  • F10.24 Alcohol dependence with alcohol-induced mood disorder
  • F10.250 Alcohol dependence with alcohol-induced psychotic disorder with delusions
  • F10.251 Alcohol dependence with alcohol-induced psychotic disorder with hallucinations
  • F10.259 Alcohol dependence with alcohol-induced psychotic disorder, unspecified
  • F10.26 Alcohol dependence with alcohol-induced persisting amnestic disorder
  • F10.27 Alcohol dependence with alcohol-induced persisting dementia
  • F10.280 Alcohol dependence with alcohol-induced anxiety disorder
  • F10.281 Alcohol dependence with alcohol-induced sexual dysfunction
  • E08.00 Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
  • E08.01 Diabetes mellitus due to underlying condition with hyperosmolarity with coma
  • E08.10 Diabetes mellitus due to underlying condition with ketoacidosis without coma
  • E08.11 Diabetes mellitus due to underlying condition with ketoacidosis with coma
  • E08.21 Diabetes mellitus due to underlying condition with diabetic nephropathy
  • E08.22 Diabetes mellitus due to underlying condition with diabetic chronic kidney disease
  • E08.29 Diabetes mellitus due to underlying condition with other diabetic kidney complication
  • E08.311 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema
  • E08.319 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema
  • E08.3211 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye
  • E08.3212 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye
  • E08.3213 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral
  • E08.3219 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E08.3291 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right eye
  • E08.3292 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, left eye
  • E08.3293 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, bilateral
  • E08.3299 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E08.3311 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye
  • E08.3312 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left eye
  • E08.3313 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
  • E08.3319 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E08.3391 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right eye
  • E08.3392 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, left eye
  • E08.3393 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
  • E08.3399 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E08.3411 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye
  • E08.3412 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left eye
  • E08.3413 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral
  • E08.3419 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E08.3491 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right eye
  • E08.3492 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, left eye
  • E08.3493 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, bilateral
  • E08.3499 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E08.3511 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye
  • E08.3512 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eye
  • E08.3513 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral
  • E08.3519 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, unspecified eye
  • E08.3521 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
  • E08.3522 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
  • E08.3523 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
  • E08.3529 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
  • E08.3531 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
  • E08.3532 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
  • E08.3533 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
  • E08.3539 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
  • E08.3541 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
  • E08.3542 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
  • E08.3543 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
  • E08.3549 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
  • E08.3551 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye
  • E08.3552 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eye
  • E08.3553 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral
  • E08.3559 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, unspecified eye
  • E08.3591 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye
  • E08.3592 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eye
  • E08.3593 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral
  • E08.3599 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, unspecified eye
  • E08.36 Diabetes mellitus due to underlying condition with diabetic cataract
  • E08.37X1 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right eye
  • E08.37X2 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, left eye
  • E08.37X3 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, bilateral
  • E08.37X9 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, unspecified eye
  • E08.39 Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication
  • E08.40 Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified
  • E08.41 Diabetes mellitus due to underlying condition with diabetic mononeuropathy
  • E08.42 Diabetes mellitus due to underlying condition with diabetic polyneuropathy
  • E08.43 Diabetes mellitus due to underlying condition with diabetic autonomic (poly)neuropathy
  • E08.44 Diabetes mellitus due to underlying condition with diabetic amyotrophy
  • E08.49 Diabetes mellitus due to underlying condition with other diabetic neurological complication
  • E08.51 Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy without gangrene
  • E08.52 Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene
  • E08.59 Diabetes mellitus due to underlying condition with other circulatory complications
  • E08.610 Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy
  • E08.618 Diabetes mellitus due to underlying condition with other diabetic arthropathy
  • E08.620 Diabetes mellitus due to underlying condition with diabetic dermatitis
  • E08.621 Diabetes mellitus due to underlying condition with foot ulcer
  • E08.622 Diabetes mellitus due to underlying condition with other skin ulcer
  • E08.628 Diabetes mellitus due to underlying condition with other skin complications
  • E08.630 Diabetes mellitus due to underlying condition with periodontal disease
  • E08.638 Diabetes mellitus due to underlying condition with other oral complications
  • E08.641 Diabetes mellitus due to underlying condition with hypoglycemia with coma
  • E08.649 Diabetes mellitus due to underlying condition with hypoglycemia without coma
  • E08.65 Diabetes mellitus due to underlying condition with hyperglycemia
  • E08.69 Diabetes mellitus due to underlying condition with other specified complication
  • E08.8 Diabetes mellitus due to underlying condition with unspecified complications
  • E08.9 Diabetes mellitus due to underlying condition without complications
  • E09.00 Drug or chemical induced diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
  • E09.01 Drug or chemical induced diabetes mellitus with hyperosmolarity with coma
  • E09.10 Drug or chemical induced diabetes mellitus with ketoacidosis without coma
  • E09.11 Drug or chemical induced diabetes mellitus with ketoacidosis with coma
  • E09.21 Drug or chemical induced diabetes mellitus with diabetic nephropathy
  • E09.22 Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease
  • E09.29 Drug or chemical induced diabetes mellitus with other diabetic kidney complication
  • E09.311 Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema
  • E09.319 Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy without macular edema
  • E09.3211 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
  • E09.3212 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
  • E09.3213 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
  • E09.3219 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E09.3291 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
  • E09.3292 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
  • E09.3293 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
  • E09.3299 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E09.3311 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
  • E09.3312 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
  • E09.3313 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
  • E09.3319 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E09.3391 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
  • E09.3392 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
  • E09.3393 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
  • E09.3399 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E09.3411 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
  • E09.3412 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
  • E09.3413 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
  • E09.3419 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E09.3491 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
  • E09.3492 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
  • E09.3493 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
  • E09.3499 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E09.3511 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
  • E09.3512 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
  • E09.3513 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
  • E09.3519 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
  • E09.3521 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
  • E09.3522 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
  • E09.3523 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
  • E09.3529 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
  • E09.3531 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
  • E09.3532 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
  • E09.3533 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
  • E09.3539 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
  • E09.3541 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
  • E09.3542 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
  • E09.3543 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
  • E09.3549 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
  • E09.3551 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, right eye
  • E09.3552 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, left eye
  • E09.3553 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
  • E09.3559 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye
  • E09.3591 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
  • E09.3592 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
  • E09.3593 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
  • E09.3599 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye
  • E09.36 Drug or chemical induced diabetes mellitus with diabetic cataract
  • E09.37X1 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
  • E09.37X2 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
  • E09.37X3 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
  • E09.37X9 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
  • E09.39 Drug or chemical induced diabetes mellitus with other diabetic ophthalmic complication
  • E09.40 Drug or chemical induced diabetes mellitus with neurological complications with diabetic neuropathy, unspecified
  • E09.41 Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy
  • E09.42 Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy
  • E09.43 Drug or chemical induced diabetes mellitus with neurological complications with diabetic autonomic (poly)neuropathy
  • E09.44 Drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy
  • E09.49 Drug or chemical induced diabetes mellitus with neurological complications with other diabetic neurological complication
  • E09.51 Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy without gangrene
  • E09.52 Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene
  • E09.59 Drug or chemical induced diabetes mellitus with other circulatory complications
  • E09.610 Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy
  • E09.618 Drug or chemical induced diabetes mellitus with other diabetic arthropathy
  • E09.620 Drug or chemical induced diabetes mellitus with diabetic dermatitis
  • E09.621 Drug or chemical induced diabetes mellitus with foot ulcer
  • E09.622 Drug or chemical induced diabetes mellitus with other skin ulcer
  • E09.628 Drug or chemical induced diabetes mellitus with other skin complications
  • E09.630 Drug or chemical induced diabetes mellitus with periodontal disease
  • E09.638 Drug or chemical induced diabetes mellitus with other oral complications
  • E09.641 Drug or chemical induced diabetes mellitus with hypoglycemia with coma
  • E09.649 Drug or chemical induced diabetes mellitus with hypoglycemia without coma
  • E09.65 Drug or chemical induced diabetes mellitus with hyperglycemia
  • E09.69 Drug or chemical induced diabetes mellitus with other specified complication
  • E09.8 Drug or chemical induced diabetes mellitus with unspecified complications
  • E09.9 Drug or chemical induced diabetes mellitus without complications
  • E10.10 Type 1 diabetes mellitus with ketoacidosis without coma
  • E10.11 Type 1 diabetes mellitus with ketoacidosis with coma
  • E10.21 Type 1 diabetes mellitus with diabetic nephropathy
  • E10.22 Type 1 diabetes mellitus with diabetic chronic kidney disease
  • E10.29 Type 1 diabetes mellitus with other diabetic kidney complication
  • E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema
  • E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema
  • E10.3211 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
  • E10.3212 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
  • E10.3213 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
  • E10.3219 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E10.3291 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
  • E10.3292 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
  • E10.3293 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
  • E10.3299 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E10.3311 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
  • E10.3312 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
  • E10.3313 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
  • E10.3319 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E10.3391 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
  • E10.3392 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
  • E10.3393 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
  • E10.3399 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E10.3411 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
  • E10.3412 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
  • E10.3413 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
  • E10.3419 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E10.3491 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
  • E10.3492 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
  • E10.3493 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
  • E10.3499 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E10.3511 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
  • E10.3512 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
  • E10.3513 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
  • E10.3519 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
  • E10.3521 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
  • E10.3522 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
  • E10.3523 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
  • E10.3529 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
  • E10.3531 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
  • E10.3532 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
  • E10.3533 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
  • E10.3539 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
  • E10.3541 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
  • E10.3542 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
  • E10.3543 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
  • E10.3549 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
  • E10.3551 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
  • E10.3552 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
  • E10.3553 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
  • E10.3559 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye
  • E10.3591 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
  • E10.3592 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
  • E10.3593 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
  • E10.3599 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye
  • E10.36 Type 1 diabetes mellitus with diabetic cataract
  • E10.37X1 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
  • E10.37X2 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
  • E10.37X3 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
  • E10.37X9 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
  • E10.39 Type 1 diabetes mellitus with other diabetic ophthalmic complication
  • E10.40 Type 1 diabetes mellitus with diabetic neuropathy, unspecified
  • E10.41 Type 1 diabetes mellitus with diabetic mononeuropathy
  • E10.42 Type 1 diabetes mellitus with diabetic polyneuropathy
  • E10.43 Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy
  • E10.44 Type 1 diabetes mellitus with diabetic amyotrophy
  • E10.49 Type 1 diabetes mellitus with other diabetic neurological complication
  • E10.51 Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene
  • E10.52 Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene
  • E10.59 Type 1 diabetes mellitus with other circulatory complications
  • E10.610 Type 1 diabetes mellitus with diabetic neuropathic arthropathy
  • E10.618 Type 1 diabetes mellitus with other diabetic arthropathy
  • E10.620 Type 1 diabetes mellitus with diabetic dermatitis
  • E10.621 Type 1 diabetes mellitus with foot ulcer
  • E10.622 Type 1 diabetes mellitus with other skin ulcer
  • E10.628 Type 1 diabetes mellitus with other skin complications
  • E10.630 Type 1 diabetes mellitus with periodontal disease
  • E10.638 Type 1 diabetes mellitus with other oral complications
  • E10.641 Type 1 diabetes mellitus with hypoglycemia with coma
  • E10.649 Type 1 diabetes mellitus with hypoglycemia without coma
  • E10.65 Type 1 diabetes mellitus with hyperglycemia
  • E10.69 Type 1 diabetes mellitus with other specified complication
  • E10.8 Type 1 diabetes mellitus with unspecified complications
  • E10.9 Type 1 diabetes mellitus without complications
  • E11.00 Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
  • E11.01 Type 2 diabetes mellitus with hyperosmolarity with coma
  • E11.21 Type 2 diabetes mellitus with diabetic nephropathy
  • E11.22 Type 2 diabetes mellitus with diabetic chronic kidney disease
  • E11.29 Type 2 diabetes mellitus with other diabetic kidney complication
  • E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema
  • E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema
  • E11.3211 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
  • E11.3212 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
  • E11.3213 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
  • E11.3219 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E11.3291 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
  • E11.3292 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
  • E11.3293 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
  • E11.3299 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E11.3311 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
  • E11.3312 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
  • E11.3313 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
  • E11.3319 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E11.3391 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
  • E11.3392 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
  • E11.3393 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
  • E11.3399 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E11.3411 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
  • E11.3412 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
  • E11.3413 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
  • E11.3419 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E11.3491 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
  • E11.3492 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
  • E11.3493 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
  • E11.3499 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E11.3511 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
  • E11.3512 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
  • E11.3513 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
  • E11.3519 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
  • E11.3521 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
  • E11.3522 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
  • E11.3523 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
  • E11.3529 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
  • E11.3531 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
  • E11.3532 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
  • E11.3533 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
  • E11.3539 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
  • E11.3541 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
  • E11.3542 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
  • E11.3543 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
  • E11.3549 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
  • E11.3551 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
  • E11.3552 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
  • E11.3553 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
  • E11.3559 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye
  • E11.3591 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
  • E11.3592 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
  • E11.3593 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
  • E11.3599 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye
  • E11.36 Type 2 diabetes mellitus with diabetic cataract
  • E11.37X1 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
  • E11.37X2 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
  • E11.37X3 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
  • E11.37X9 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
  • E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication
  • E11.40 Type 2 diabetes mellitus with diabetic neuropathy, unspecified
  • E11.41 Type 2 diabetes mellitus with diabetic mononeuropathy
  • E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy
  • E11.43 Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy
  • E11.44 Type 2 diabetes mellitus with diabetic amyotrophy
  • E11.49 Type 2 diabetes mellitus with other diabetic neurological complication
  • E11.51 Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
  • E11.52 Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
  • E11.59 Type 2 diabetes mellitus with other circulatory complications
  • E11.610 Type 2 diabetes mellitus with diabetic neuropathic arthropathy
  • E11.618 Type 2 diabetes mellitus with other diabetic arthropathy
  • E11.620 Type 2 diabetes mellitus with diabetic dermatitis
  • E11.621 Type 2 diabetes mellitus with foot ulcer
  • E11.622 Type 2 diabetes mellitus with other skin ulcer
  • E11.628 Type 2 diabetes mellitus with other skin complications
  • E11.630 Type 2 diabetes mellitus with periodontal disease
  • E11.638 Type 2 diabetes mellitus with other oral complications
  • E11.641 Type 2 diabetes mellitus with hypoglycemia with coma
  • E11.649 Type 2 diabetes mellitus with hypoglycemia without coma
  • E11.65 Type 2 diabetes mellitus with hyperglycemia
  • E11.69 Type 2 diabetes mellitus with other specified complication
  • E11.8 Type 2 diabetes mellitus with unspecified complications
  • E11.9 Type 2 diabetes mellitus without complications
  • E13.00 Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
  • E13.01 Other specified diabetes mellitus with hyperosmolarity with coma
  • E13.10 Other specified diabetes mellitus with ketoacidosis without coma
  • E13.11 Other specified diabetes mellitus with ketoacidosis with coma
  • E13.21 Other specified diabetes mellitus with diabetic nephropathy
  • E13.22 Other specified diabetes mellitus with diabetic chronic kidney disease
  • E13.29 Other specified diabetes mellitus with other diabetic kidney complication
  • E13.311 Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema
  • E13.319 Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema
  • E13.3211 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
  • E13.3212 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
  • E13.3213 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
  • E13.3219 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E13.3291 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
  • E13.3292 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
  • E13.3293 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
  • E13.3299 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E13.3311 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
  • E13.3312 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
  • E13.3313 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
  • E13.3319 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E13.3391 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
  • E13.3392 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
  • E13.3393 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
  • E13.3399 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E13.3411 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
  • E13.3412 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
  • E13.3413 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
  • E13.3419 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E13.3491 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
  • E13.3492 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
  • E13.3493 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
  • E13.3499 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E13.3511 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
  • E13.3512 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
  • E13.3513 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
  • E13.3519 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
  • E13.3521 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
  • E13.3522 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
  • E13.3523 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
  • E13.3529 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
  • E13.3531 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
  • E13.3532 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
  • E13.3533 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
  • E13.3539 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
  • E13.3541 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
  • E13.3542 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
  • E13.3543 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
  • E13.3549 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
  • E13.3551 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye
  • E13.3552 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left eye
  • E13.3553 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
  • E13.3559 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye
  • E13.3591 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
  • E13.3592 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
  • E13.3593 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
  • E13.3599 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye
  • E13.36 Other specified diabetes mellitus with diabetic cataract
  • E13.37X1 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
  • E13.37X2 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
  • E13.37X3 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
  • E13.37X9 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
  • E13.39 Other specified diabetes mellitus with other diabetic ophthalmic complication
  • E13.40 Other specified diabetes mellitus with diabetic neuropathy, unspecified
  • E13.41 Other specified diabetes mellitus with diabetic mononeuropathy
  • E13.42 Other specified diabetes mellitus with diabetic polyneuropathy
  • E13.43 Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy
  • E13.44 Other specified diabetes mellitus with diabetic amyotrophy
  • E13.49 Other specified diabetes mellitus with other diabetic neurological complication
  • E13.51 Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene
  • E13.52 Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene
  • E13.59 Other specified diabetes mellitus with other circulatory complications
  • E13.610 Other specified diabetes mellitus with diabetic neuropathic arthropathy
  • E13.618 Other specified diabetes mellitus with other diabetic arthropathy
  • E13.620 Other specified diabetes mellitus with diabetic dermatitis
  • E13.621 Other specified diabetes mellitus with foot ulcer
  • E13.622 Other specified diabetes mellitus with other skin ulcer
  • E13.628 Other specified diabetes mellitus with other skin complications
  • E13.630 Other specified diabetes mellitus with periodontal disease
  • E13.638 Other specified diabetes mellitus with other oral complications
  • E13.641 Other specified diabetes mellitus with hypoglycemia with coma
  • E13.649 Other specified diabetes mellitus with hypoglycemia without coma
  • E13.65 Other specified diabetes mellitus with hyperglycemia
  • E13.69 Other specified diabetes mellitus with other specified complication
  • E13.8 Other specified diabetes mellitus with unspecified complications
  • E13.9 Other specified diabetes mellitus without complications
  • R73.01 Impaired fasting glucose
  • R73.02 Impaired glucose tolerance (oral)
  • R73.03 Prediabetes
  • R73.09 Other abnormal glucose
  • R73.9 Hyperglycemia, unspecified
  • Z13.1 Encounter for screening for diabetes mellitus
  • Z83.3 Family history of diabetes mellitus
  • Z86.32 Personal history of gestational diabetes

Frequency

  • Initial year: Up to 10 hours of initial training within a continuous 12-month period
  • Subsequent years: Up to 2 hours of follow-up training each year after the initial year

Medicare Beneficiary Pays

  • Copayment/coinsurance applies
  • Deductible applies

ICD 10 CM Updates

New Rules for CPT Category III T Codes

Attach the Medical Records at initial Claim Submission Please note that when submitting your initial claim for any one of the CPT codes spec...