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Diabetic retinopathy is best diagnosed with a dilated eye exam. For this exam, drops placed in your eyes widen (dilate) your pupils to allow your doctor to better view inside your eyes. The drops may cause your close vision to blur until they wear off, several hours later.
For diabetic beneficiaries, the primary diagnosis on the claim should also be routine vision screening, with diabetes listed as a secondary diagnosis. Failure to include the routine diagnosis or using an evaluation and management (E&M) procedure code may cause the claim to process as a diagnostic eye exam.