CMS Expands List of Manifestation Codes under ICD-10 Effective 10-1-16

This week, the Centers for Medicare & Medicaid Services (CMS) issued Change Request 9754/Transmittal 3591, the October 2016 Integrated Outpatient Code Editor (I/OCE) Specifications Version 17.3. The document provides updates for the I/OCE that will be applicable for various Medicare services beginning October 1, 2016. Among the changes included in the transmittal is a list of new codes related to diabetes mellitus that will be included in the list of “manifestation codes” in the ICD-10. These codes should be of particular interest to hospice providers as, effective beginning October 1, 2014, use of any manifestation code as a principal diagnosis on a claim for purposes of hospice care has resulted in the claim being returned to provider (RTP). It should also be noted that beginning October 3, 2016, CMS is implementing an edit in the Fiscal Intermediary Shared System (FISS) to RTP a hospice Notice of Election (NOE) if it does not contain a principal diagnosis.


Code Changes for 10-1-2016

  • Following is a list of diagnosis codes that are being added to the list of ICD-10 manifestation codes effective October 1, along with their descriptions:
  • E083211: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye
  • E083212: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye
  • E083213: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral
  • E083219: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E083291: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right eye
  • E083292: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, left eye
  • E083293: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, bilateral
  • E083299: Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E083311: Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye
  • E083312: Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left eye
  • E083313: Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
  • E083319: Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E083391: Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right eye
  • E083392: Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, left eye
  • E083393: Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
  • E083399: Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E083411: Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye
  • E083412: Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left eye
  • E083413: Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral
  • E083419: Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
  • E083491: Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right eye
  • E083492: Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, left eye
  • E083493: Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, bilateral
  • E083499: Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
  • E083511: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye
  • E083512: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eye
  • E083513: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral
  • E083519: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, unspecified eye
  • E083521: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
  • E083522: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
  • E083523: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
  • E083529: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
  • E083531: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
  • E083532: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
  • E083533: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
  • E083539: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
  • E083541: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
  • E083542: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
  • E083543: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
  • E083549: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
  • E083551: Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye
  • E083552: Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eye
  • E083553: Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral
  • E083559: Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, unspecified eye
  • E083591: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye
  • E083592: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eye
  • E083593: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral
  • E083599: Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, unspecified eye
  • E0837X1: Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right eye
  • E0837X2: Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, left eye
  • E0837X3: Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, bilateral
  • E0837X9: Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, unspecified eye