Reimbursement
LUCENTIS Sample Coding
This coding information may assist you as you complete the payer forms for LUCENTIS. These tables are provided for informational purposes only. Please visit CMS.gov or other payers’ websites to obtain additional guidance on their processes related to billing and coding for single-use vials and wastage.
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Diabetic Macular Edema (DME)
| TYPE | CODE | DESCRIPTION | |
|---|---|---|---|
| Diagnosis: ICD-10-CM | E08.311 | Diabetes due to underlying condition with unspecified diabetic retinopathy with 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 | ||
| E08.3311 | 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 | ||
| E08.3411 | 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 | ||
| E08.3511 | 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 | ||
| E08.37X1 | Diabetes mellitus due to underlying condition with macular edema resolved following treatment, right eye | ||
| E08.37X2 | Diabetes mellitus due to underlying condition with macular edema resolved following treatment, left eye | ||
| E08.37X3 | Diabetes mellitus due to underlying condition with macular edema resolved following treatment, bilateral | ||
| E08.37X9 | Diabetes mellitus due to underlying condition with macular edema resolved following treatment, unspecified eye | ||
| E09.311 | Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with 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 | ||
| E09.3311 | 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 | ||
| E09.3411 | 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 | ||
| E09.3511 | 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 | ||
| E09.37X1 | 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 | ||
| E10.311 | Type 1 diabetes with unspecified diabetic retinopathy with 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 | ||
| E10.3311 | 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 | ||
| E10.3411 | 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 | ||
| E10.3511 | 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 | ||
| E10.37X1 | Type 1 Diabetes mellitus with macular edema resolved following treatment, right eye | ||
| E10.37X2 | Type 1 Diabetes mellitus with macular edema resolved following treatment, left eye | ||
| E10.37X3 | Type 1 Diabetes mellitus with macular edema resolved following treatment, bilateral | ||
| E10.37X9 | Type 1 Diabetes mellitus with macular edema resolved following treatment, unspecified eye | ||
| E11.311 | Type 2 diabetes with unspecified diabetic retinopathy with 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 | ||
| E11.3311 | 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 | ||
| E11.3411 | 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 | ||
| E11.3511 | 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 | ||
| E11.37X1 | Type 2 Diabetes mellitus with macular edema resolved following treatment, right eye | ||
| E11.37X2 | Type 2 Diabetes mellitus with macular edema resolved following treatment, left eye | ||
| E11.37X3 | Type 2 Diabetes mellitus with macular edema resolved following treatment, bilateral | ||
| E11.37X9 | Type 2 Diabetes mellitus with macular edema resolved following treatment, unspecified eye | ||
| E13.311 | Other specified diabetes with unspecified diabetic retinopathy with 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 | ||
| E13.3311 | 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 | ||
| E13.3411 | 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 | ||
| E13.3511 | 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 | ||
| E13.37X1 | Other specified Diabetes mellitus with macular edema resolved following treatment, right eye | ||
| E13.37X2 | Other specified Diabetes mellitus with macular edema resolved following treatment, left eye | ||
| E13.37X3 | Other Specified Diabetes mellitus with macular edema resolved following treatment, bilateral | ||
| E13.37X9 | Other Specified Diabetes mellitus with macular edema resolved following treatment, unspecified eye | ||
| Drug: HCPCS | J2778 | Injection, ranibizumab, 0.1 mg (bill 3 units) | |
| Drug: NDC Note: Payer requirements regarding use of a 10-digit or 11-digit NDC may vary. Both formats are listed here for your reference. | 10-digit | 11-digit | |
| 50242-082-02 | 50242-0082-02 |
LUCENTIS 0.3-mg vial | |
| 50242-082-03 | 50242-0082-03 |
LUCENTIS 0.3-mg prefilled syringe | |
| Administration procedures: CPT | 67028 | Intravitreal injection of a pharmacologic agent (separate procedure) | |
| CPT modifier | –LT | Left eye modifier | |
| –RT | Right eye modifier | ||
CPT=Current Procedural Terminology.
DME=diabetic macular edema.
HCPCS=Healthcare Common Procedure
Coding System.
ICD-10-CM=International Classification of
Diseases, 10th Revision, Clinical Modification.
LT=left.
NDC=National Drug Code.
NOS=not otherwise specified.
RT=right.
Macular Edema Following Retinal Vein Occlusion (RVO)
| TYPE | CODE | DESCRIPTION | |
|---|---|---|---|
| Diagnosis: ICD-10-CM | H34.8110 | Central retinal vein occlusion, right eye, with macular edema | |
| H34.8111 | Central retinal vein occlusion, right eye, with retinal revascularization | ||
| H34.8112 | Central retinal vein occlusion, right eye, stable | ||
| H34.8120 | Central retinal vein occlusion, left eye, with macular edema | ||
| H34.8121 | Central retinal vein occlusion, left eye, with retinal revascularization | ||
| H34.8122 | Central retinal vein occlusion, left eye, stable | ||
| H34.8130 | Central retinal vein occlusion, bilateral, with macular edema | ||
| H34.8131 | Central retinal vein occlusion, bilateral, with retinal revascularization | ||
| H34.8132 | Central retinal vein occlusion, bilateral, stable | ||
| H34.8190 | Central retinal vein occlusion, unspecified eye, with macular edema | ||
| H34.8191 | Central retinal vein occlusion, unspecified eye, with retinal revascularization | ||
| H34.8192 | Central retinal vein occlusion, unspecified eye, stable | ||
| H34.8310 | Tributary (branch) retinal vein occlusion, right eye, with macular edema | ||
| H34.8311 | Tributary (branch) retinal vein occlusion, right eye, with retinal revascularization | ||
| H34.8312 | Tributary (branch) retinal vein occlusion, right eye, stable | ||
| H34.8320 | Tributary (branch) retinal vein occlusion, left eye, with macular edema | ||
| H34.8321 | Tributary (branch) retinal vein occlusion, left eye, with retinal revascularization | ||
| H34.8322 | Tributary (branch) retinal vein occlusion, left eye, stable | ||
| H34.8330 | Tributary (branch) retinal vein occlusion, bilateral, with macular edema | ||
| H34.8331 | Tributary (branch) retinal vein occlusion, bilateral, with retinal revascularization | ||
| H34.8332 | Tributary (branch) retinal vein occlusion, bilateral, stable | ||
| H34.8390 | Tributary (branch) retinal vein occlusion, unspecified eye, with macular edema | ||
| H34.8391 | Tributary (branch) retinal vein occlusion, unspecified eye, with retinal revascularization | ||
| H34.8392 | Tributary (branch) retinal vein occlusion, unspecified eye, stable | ||
| Drug: HCPCS | J2778 | Injection, ranibizumab, 0.1 mg (bill 5 units) | |
| Drug: NDC Note: Payer requirements regarding use of a 10-digit or 11-digit NDC may vary. Both formats are listed here for your reference. | 10-digit | 11-digit | |
| 50242-080-02 | 50242-0080-02 | LUCENTIS 0.5-mg
vial | |
| 50242-080-03 | 50242-0080-03 | LUCENTIS 0.5-mg
prefilled syringe | |
| Administration procedures: CPT | 67028 | Intravitreal injection of a pharmacologic agent (separate procedure) | |
| CPT modifier | –LT | Left eye modifier | |
| –RT | Right eye modifier | ||
CPT=Current Procedural Terminology.
HCPCS=Healthcare Common Procedure Coding System.
ICD-10-CM=International Classification of Diseases, 10th Revision,
Clinical Modification.
LT=left.
NDC=National Drug
Code.
RT=right.
Wet-Age Related Macular Degeneration (wet AMD)
| TYPE | CODE | DESCRIPTION | |
|---|---|---|---|
| Diagnosis: ICD-10-CM | H35.3210 | Exudative age-related macular degeneration, right eye, stage unspecified | |
| H35.3211 | Exudative age-related macular degeneration, right eye, with active choroidal neovascularization | ||
| H35.3212 | Exudative age-related macular degeneration, right eye, with inactive choroidal neovascularization | ||
| H35.3213 | Exudative age-related macular degeneration, right eye, with inactive scar | ||
| H35.3220 | Exudative age-related macular degeneration, left eye, stage unspecified | ||
| H35.3221 | Exudative age-related macular degeneration, left eye, with active choroidal neovascularization | ||
| H35.3222 | Exudative age-related macular degeneration, left eye, with inactive choroidal neovascularization | ||
| H35.3223 | Exudative age-related macular degeneration, left eye, with inactive scar | ||
| H35.3230 | Exudative age-related macular degeneration, bilateral, stage unspecified | ||
| H35.3231 | Exudative age-related macular degeneration, bilateral, with active choroidal neovascularization | ||
| H35.3232 | Exudative age-related macular degeneration, bilateral, with inactive choroidal neovascularization | ||
| H35.3233 | Exudative age-related macular degeneration, bilateral, with inactive scar | ||
| H35.3290 | Exudative age-related macular degeneration, unspecified eye, stage unspecified | ||
| H35.3291 | Exudative age-related macular degeneration, unspecified eye, with active choroidal neovascularization | ||
| H35.3292 | Exudative age-related macular degeneration, unspecified eye, with inactive choroidal neovascularization | ||
| H35.3293 | Exudative age-related macular degeneration, unspecified eye, with inactive scar | ||
| Drug: HCPCS | J2778 | Injection, ranibizumab, 0.1 mg (bill 5 units) | |
| Drug: NDC Note: Payer requirements regarding use of a 10-digit or 11-digit NDC may vary. Both formats are listed here for your reference. | 10-digit | 11-digit | |
| 50242-080-02 | 50242-0080-02 | LUCENTIS 0.5-mg
vial | |
| 50242-080-03 | 50242-0080-03 | LUCENTIS 0.5-mg
prefilled syringe | |
| Administration procedures: CPT | 67028 | Intravitreal injection of a pharmacologic agent (separate procedure) | |
| CPT modifier | –LT | Left eye modifier | |
| –RT | Right eye modifier | ||
AMD=age-related macular degeneration.
CPT=Current Procedural Terminology.
HCPCS=Healthcare Common
Procedure Coding System.
ICD-10-CM=International Classification
of Diseases, 10th Revision, Clinical Modification.
LT=left.
NDC=National Drug Code.
RT=right.
Diabetic Retinopathy (Non Proliferative DR [NPDR] and Proliferative DR [PDR])
| TYPE | CODE | DESCRIPTION | |
|---|---|---|---|
| Diagnosis: ICD-10-CM | 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 | ||
| E08.37X1 | Diabetes mellitus due to underlying condition with macular edema resolved following treatment, right eye | ||
| E08.37X2 | Diabetes mellitus due to underlying condition with macular edema resolved following treatment, left eye | ||
| E08.37X3 | Diabetes mellitus due to underlying condition with macular edema resolved following treatment, bilateral | ||
| E08.37X9 | Diabetes mellitus due to underlying condition with macular edema resolved following treatment, unspecified eye | ||
| 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 | ||
| E09.37x1 | 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 | ||
| E10.311 | Type 1 diabetes 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 | ||
| E10.37X1 | Type 1 diabetes mellitus with macular edema resolved following treatment, right eye | ||
| E10.37X2 | Type 1 diabetes mellitus with macular edema resolved following treatment, left eye | ||
| E10.37X3 | Type 1 diabetes mellitus with macular edema resolved following treatment, bilateral | ||
| E10.37X9 | Type 1 diabetes mellitus with macular edema resolved following treatment, unspecified eye | ||
| E11.311 | Type 2 diabetes 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 | ||
| E11.37X1 | Type 2 diabetes mellitus with macular edema resolved following treatment, right eye | ||
| E11.37X2 | Type 2 diabetes mellitus with macular edema resolved following treatment, left eye | ||
| E11.37X3 | Type 2 diabetes mellitus with macular edema resolved following treatment, bilateral | ||
| E11.37X9 | Type 2 diabetes mellitus with macular edema resolved following treatment, unspecified eye | ||
| E13.311 | Other specified diabetes 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 | ||
| E13.37X1 | Other specified diabetes mellitus with macular edema resolved following treatment, right eye | ||
| E13.37X2 | Other specified diabetes mellitus with macular edema resolved following treatment, left eye | ||
| E13.37X3 | Other specified diabetes mellitus with macular edema resolved following treatment, bilateral | ||
| E13.37X9 | Other specified diabetes mellitus with macular edema resolved following treatment, unspecified eye | ||
| Drug: HCPCS | J2778 | Injection, ranibizumab, 0.1 mg (bill 3 units) | |
| Drug: NDC Note: Payer requirements regarding use of a 10-digit or 11-digit NDC may vary. Both formats are listed here for your reference. | 10-digit | 11-digit | |
| 50242-082-02 | 50242-0082-02 | LUCENTIS 0.3-mg
vial | |
| 50242-082-03 | 50242-0082-03 | LUCENTIS 0.3-mg
prefilled syringe | |
| Administration procedures: CPT | 67028 | Intravitreal injection of a pharmacologic agent (separate procedure) | |
| CPT modifier | –LT | Left eye modifier | |
| –RT | Right eye modifier | ||
CPT=Current Procedural Terminology.
DME=diabetic macular edema.
HCPCS=Healthcare Common Procedure
Coding System.
ICD-10-CM=International Classification of
Diseases, 10th Revision, Clinical Modification.
LT=left.
NDC=National Drug Code.
NOS=not otherwise specified.
RT=right.
Myopic Choroidal Neovascularization (mCNV)
| TYPE | CODE | DESCRIPTION | |
|---|---|---|---|
| Diagnosis: ICD-10-CM | H35.051 | Retinal neovascularization,
unspecified, right eye | |
| H35.052 | Retinal neovascularization, unspecified, left eye | ||
| H35.053 | Retinal neovascularization, unspecified, bilateral | ||
| H35.059 | Retinal neovascularization, unspecified, unspecified eye | ||
| H44.20 | Degenerative myopia, unspecified eye | ||
| H44.21 | Degenerative myopia, right eye | ||
| H44.22 | Degenerative myopia, left eye | ||
| H44.23 | Degenerative myopia, bilateral | ||
| H44.2A1 | Degenerative myopia with
choroidal neovascularization, right eye | ||
| H44.2A2 | Degenerative myopia with
choroidal neovascularization, left eye | ||
| H44.2A3 | Degenerative myopia with
choroidal neovascularization, bilateral eye | ||
| H44.2A9 | Degenerative myopia with
choroidal neovascularization, unspecified eye | ||
| Drug: HCPCS | J2778 | Injection, ranibizumab, 0.1 mg (bill 5 units) | |
| Drug: NDC Note: Payer requirements regarding use of a 10-digit or 11-digit NDC may vary. Both formats are listed here for your reference. | 10-digit | 11-digit | |
| 50242-080-02 | 50242-0080-02 | LUCENTIS 0.5-mg vial | |
| 50242-080-03 | 50242-0080-03 | LUCENTIS 0.5-mg prefilled syringe | |
| Administration procedures: CPT | 67028 | Intravitreal injection of a pharmacologic agent (separate procedure) | |
| CPT modifier | –LT | Left eye modifier | |
| –RT | Right eye modifier | ||
AMD=age-related macular degeneration.
CPT=Current Procedural Terminology.
HCPCS=Healthcare Common
Procedure Coding System.
ICD-10-CM=International Classification
of Diseases, 10th Revision, Clinical Modification.
LT=left.
NDC=National Drug Code.
RT=right.
These codes are not all-inclusive; appropriate codes can vary by patient, setting of care and payer. Correct coding is the responsibility of the provider submitting the claim for the item or service. Please check with the payer to verify codes and special billing requirements. Genentech does not make any representation or guarantee concerning reimbursement or coverage for any service or item.
Many payers will not accept unspecified codes. If you use an unspecified code, please check with your payer.
Appeals
If your patient’s health insurance plan has issued a denial, your Retina Field Reimbursement Manager (RFRM) or LUCENTIS Access Solutions Specialist can provide resources as you prepare an appeal submission, as per your patient’s plan requirements.
If a plan issues a denial:
- The denial should be reviewed, along with the health insurance
plan’s guidelines to determine what to include in your patient’s
appeal submission.
- Your RFRM or LUCENTIS Access
Solutions Specialist has local payer coverage expertise and can help
you determine specific requirements for your patient.
A sample appeal letter and additional considerations are available in Forms and Documents.
Appeals cannot be completed or submitted by LUCENTIS Access Solutions on your behalf.
PAN=Patient Authorization and Notice of Request
for Transmission of Health Information to Genentech Access Solutions
and Genentech® Access to Care Foundation.
SMN=Statement of Medical Necessity.
Important Safety Information & Indication
Indications
LUCENTIS® (ranibizumab injection) is indicated for the treatment of patients with:
- Neovascular (wet) age-related macular degeneration (wAMD)
- Macular edema following retinal vein occlusion (RVO)
- Diabetic macular edema (DME)
- Diabetic retinopathy (DR)
- Myopic choroidal neovascularization (mCNV)
Important Safety Information
LUCENTIS is contraindicated in patients with ocular or periocular infections or known hypersensitivity to ranibizumab or any of the excipients in LUCENTIS. Hypersensitivity reactions may manifest as severe intraocular inflammation.
WARNINGS AND PRECAUTIONS
Intravitreal injections, including those with LUCENTIS, have been associated with endophthalmitis, retinal detachment, and iatrogenic traumatic cataract.
Increases in intraocular pressure have been noted both pre-injection and post-injection with LUCENTIS.
Although there was a low rate of arterial thromboembolic events (ATEs) observed in the LUCENTIS clinical trials, there is a potential risk of ATEs following intravitreal use of VEGF inhibitors. ATEs are defined as nonfatal stroke, nonfatal myocardial infarction, or vascular death (including deaths of unknown cause).
Fatal events occurred more frequently in patients with DME and DR at baseline treated monthly with LUCENTIS compared with control. Although the rate of fatal events was low and included causes of death typical of patients with advanced diabetic complications, a potential relationship between these events and intravitreal use of VEGF inhibitors cannot be excluded.
In the LUCENTIS Phase III clinical trials, the most common ocular side effects included conjunctival hemorrhage, eye pain, vitreous floaters, and increased intraocular pressure. The most common non-ocular side effects included nasopharyngitis, anemia, nausea, and cough.
For additional safety information, please see LUCENTIS full prescribing information.
You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.