Notification



Notification Issue Date:



Policy Attachment


Attachment to Policy # 07.07.01o


Attachment:B

Policy #:07.07.01o

Description:ICD-10 CM Codes Eligible to be Reported for Routine Foot Care for Certain Medical Conditions (E10.22 - E13.3512), Continued

Title:Routine Foot Care for Certain Medical Conditions


Inclusion of a code in this table does not imply reimbursement. Eligibility, benefits, limitations, exclusions, precertification/referral requirements, provider contracts, and Company policies apply.

The codes listed below are updated on a regular basis, in accordance with nationally accepted coding guidelines. Therefore, this policy applies to any and all future applicable coding changes, revisions, or updates.

In order to ensure optimal reimbursement, all health care services, devices, and pharmaceuticals should be reported using the billing codes and modifiers that most accurately represent the services rendered, unless otherwise directed by the Company.


INTERNATIONAL CLASSIFICATION OF DISEASES (ICD-10) DIAGNOSIS CODES ASSOCIATED WITH ROUTINE FOOT CARE (Continued)

E10.22Type 1 diabetes mellitus with diabetic chronic kidney disease
E10.29Type 1 diabetes mellitus with other diabetic kidney complication
E10.311Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema
E10.319Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema
E10.3211Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E10.3212Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E10.3213Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3219Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
E10.3291Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E10.3292Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E10.3293Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3299Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
E10.3311Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E10.3312Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E10.3313Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3319Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
E10.3391Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E10.3392Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E10.3393Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3399Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
E10.3411Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E10.3412Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E10.3413Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3419Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
E10.3491Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E10.3492Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E10.3493Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3499Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
E10.3511Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E10.3512Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E10.3513Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E10.3519Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
E10.3521Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E10.3522Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E10.3523Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E10.3529Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
E10.3531Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E10.3532Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E10.3533Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E10.3539Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
E10.3541Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E10.3542Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E10.3543Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E10.3549Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
E10.3551Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E10.3552Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E10.3553Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E10.3559Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye
E10.3591Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E10.3592Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E10.3593Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E10.3599Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye
E10.36Type 1 diabetes mellitus with diabetic cataract
E10.39Type 1 diabetes mellitus with other diabetic ophthalmic complication
E10.40Type 1 diabetes mellitus with diabetic neuropathy, unspecified
E10.41Type 1 diabetes mellitus with diabetic mononeuropathy
E10.42Type 1 diabetes mellitus with diabetic polyneuropathy
E10.43Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy
E10.44Type 1 diabetes mellitus with diabetic amyotrophy
E10.49Type 1 diabetes mellitus with other diabetic neurological complication
E10.51Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene
E10.52Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene
E10.59Type 1 diabetes mellitus with other circulatory complications
E10.610Type 1 diabetes mellitus with diabetic neuropathic arthropathy
E10.618Type 1 diabetes mellitus with other diabetic arthropathy
E10.620Type 1 diabetes mellitus with diabetic dermatitis
E10.621Type 1 diabetes mellitus with foot ulcer
E10.622Type 1 diabetes mellitus with other skin ulcer
E10.628Type 1 diabetes mellitus with other skin complications
E10.630Type 1 diabetes mellitus with periodontal disease
E10.638Type 1 diabetes mellitus with other oral complications
E10.641Type 1 diabetes mellitus with hypoglycemia with coma
E10.649Type 1 diabetes mellitus with hypoglycemia without coma
E10.65Type 1 diabetes mellitus with hyperglycemia
E10.69Type 1 diabetes mellitus with other specified complication
E10.8Type 1 diabetes mellitus with unspecified complications
E10.9Type 1 diabetes mellitus without complications
E11.00Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E11.01Type 2 diabetes mellitus with hyperosmolarity with coma
E11.10Type 2 diabetes mellitus with ketoacidosis without coma
E11.11Type 2 diabetes mellitus with ketoacidosis with coma
E11.21Type 2 diabetes mellitus with diabetic nephropathy
E11.22Type 2 diabetes mellitus with diabetic chronic kidney disease
E11.29Type 2 diabetes mellitus with other diabetic kidney complication
E11.311Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema
E11.319Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema
E11.3211Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E11.3212Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E11.3213Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3219Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
E11.3291Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E11.3292Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E11.3293Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3299Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
E11.3311Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E11.3312Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E11.3313Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3319Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
E11.3391Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E11.3392Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E11.3393Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3399Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
E11.3411Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E11.3412Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E11.3413Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3419Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
E11.3491Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E11.3492Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E11.3493Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3499Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
E11.3511Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E11.3512Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E11.3513Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E11.3519Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
E11.3521Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E11.3522Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E11.3523Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E11.3529Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
E11.3531Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E11.3532Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E11.3533Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E11.3539Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
E11.3541Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E11.3542Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E11.3543Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E11.3549Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
E11.3551Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E11.3552Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E11.3553Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E11.3559Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye
E11.3591Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E11.3592Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E11.3593Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E11.3599Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye
E11.36Type 2 diabetes mellitus with diabetic cataract
E11.37X1Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
E11.37X2Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
E11.37X3Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
E11.37X9Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
E11.39Type 2 diabetes mellitus with other diabetic ophthalmic complication
E11.40Type 2 diabetes mellitus with diabetic neuropathy, unspecified
E11.41Type 2 diabetes mellitus with diabetic mononeuropathy
E11.42Type 2 diabetes mellitus with diabetic polyneuropathy
E11.43Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy
E11.44Type 2 diabetes mellitus with diabetic amyotrophy
E11.49Type 2 diabetes mellitus with other diabetic neurological complication
E11.51Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
E11.52Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
E11.59Type 2 diabetes mellitus with other circulatory complications
E11.610Type 2 diabetes mellitus with diabetic neuropathic arthropathy
E11.618Type 2 diabetes mellitus with other diabetic arthropathy
E11.620Type 2 diabetes mellitus with diabetic dermatitis
E11.621Type 2 diabetes mellitus with foot ulcer
E11.622Type 2 diabetes mellitus with other skin ulcer
E11.628Type 2 diabetes mellitus with other skin complications
E11.630Type 2 diabetes mellitus with periodontal disease
E11.638Type 2 diabetes mellitus with other oral complications
E11.641Type 2 diabetes mellitus with hypoglycemia with coma
E11.649Type 2 diabetes mellitus with hypoglycemia without coma
E11.65Type 2 diabetes mellitus with hyperglycemia
E11.69Type 2 diabetes mellitus with other specified complication
E11.8Type 2 diabetes mellitus with unspecified complications
E11.9Type 2 diabetes mellitus without complications
E13.00Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E13.01Other specified diabetes mellitus with hyperosmolarity with coma
E13.10Other specified diabetes mellitus with ketoacidosis without coma
E13.11Other specified diabetes mellitus with ketoacidosis with coma
E13.21Other specified diabetes mellitus with diabetic nephropathy
E13.22Other specified diabetes mellitus with diabetic chronic kidney disease
E13.29Other specified diabetes mellitus with other diabetic kidney complication
E13.311Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema
E13.319Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema
E13.3211Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E13.3212Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E13.3213Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3219Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
E13.3291Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E13.3292Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E13.3293Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3299Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
E13.3311Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E13.3312Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E13.3313Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3319Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
E13.3391Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E13.3392Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E13.3393Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3399Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
E13.3411Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E13.3412Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E13.3413Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3419Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
E13.3491Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E13.3492Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E13.3493Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3499Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
E13.3511Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E13.3512Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye

Version Effective Date: 10/01/2019
Version Issued Date: 10/02/2019
Version Reissued Date: N/A

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Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.