ICD-9 Code 362.04

Mild nonproliferative diabetic retinopathy

Not Valid for Submission

362.04 is a legacy non-billable code used to specify a medical diagnosis of mild nonproliferative diabetic retinopathy. This code was replaced on September 30, 2015 by its ICD-10 equivalent.

ICD-9: 362.04
Short Description:Mild nonprolf db retnoph
Long Description:Mild nonproliferative diabetic retinopathy

Convert 362.04 to ICD-10

The following crosswalk between ICD-9 to ICD-10 is based based on the General Equivalence Mappings (GEMS) information:

  • E11.329 - Type 2 diab w mild nonprlf diabetic rtnop w/o macular edema

Code Classification

  • Diseases of the sense organs (360–389)
    • Disorders of the eye and adnexa (360-379)
      • 362 Other retinal disorders

Information for Medical Professionals

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-9 Code Edits are applicable to this code:

Index to Diseases and Injuries

References found for the code 362.04 in the Index of Diseases and Injuries:

    • Diabetes diabetic brittle congenital familial mellitus severe slight without complication 250.0
      • retinopathy 250.5 362.01
        • nonproliferative 250.5 362.03
          • mild 250.5 362.04
            • due to secondary diabetes 249.5 362.04
      • secondary chemical induced due to chronic condition due to infection drug induced 249.0
        • retinopathy 249.5 362.01
          • nonproliferative 249.5 362.03
            • mild 249.5 362.04
    • Retinopathy background 362.10
      • diabetic 250.5 362.01
        • nonproliferative 250.5 362.03
          • mild 250.5 362.04
            • due to secondary diabetes 249.5 362.04
      • nonproliferative
        • diabetic 250.5 362.03
          • mild 250.5 362.04
            • due to secondary diabetes 249.5 362.04

Information for Patients


Diabetic Eye Problems

Also called: Diabetic retinopathy

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can damage your eyes. The most common problem is diabetic retinopathy. It is a leading cause of blindness in American adults.

Your retina is the light-sensitive tissue at the back of your eye. You need a healthy retina to see clearly. Diabetic retinopathy damages the tiny blood vessels inside your retina.

You may not notice it at first. Symptoms can include

  • Blurry or double vision
  • Rings, flashing lights, or blank spots
  • Dark or floating spots
  • Pain or pressure in one or both of your eyes
  • Trouble seeing things out of the corners of your eyes

Treatment often includes laser treatment or surgery, with follow-up care.

Two other eye problems can happen to people with diabetes. A cataract is a cloud over the lens of your eye. Surgery helps you see clearly again. Glaucoma happens when pressure builds up in the eye, damaging the main nerve. Eye drops or surgery can help.

If you have diabetes, you should have a complete eye exam every year. Finding and treating problems early may save your vision.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

  • Diabetes - eye care
  • Diabetes and eye disease
  • Diabetes eye exams
  • Fluorescein angiography
  • Intravitreal injection
  • Standard ophthalmic exam

[Read More]

ICD-9 Footnotes

General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.

Index of Diseases and Injuries Definitions

  • And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
  • Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
  • Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
  • Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
  • Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
  • Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
  • NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
  • See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
  • See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
  • 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
  • With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.