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.
The following crosswalk between ICD-9 to ICD-10 is based based on the General Equivalence Mappings (GEMS) information:
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:
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.
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.
On January 16, 2009, the U.S. Department of Health and Human Services (HHS) released the final rule mandating that everyone covered by the Health Insurance Portability and Accountability Act (HIPAA) implement ICD-10 for medical coding.
On December 7, 2011, CMS released a final rule updating payers' medical loss ratio to account for ICD-10 conversion costs. Effective January 3, 2012, the rule allows payers to switch some ICD-10 transition costs from the category of administrative costs to clinical costs, which will help payers cover transition costs.