Wiki Coding Insulin Z79.4 with Diabetes Type 1

[8682mu]

Is there an updated coding clinic that says "Not" to code Insulin with Diabetes?
I was audit and got an error for not capturing Z79.4 for patient with Type 1 Diabetes. I disagreed and said
Type 1 Diabetes is an insulin dependent disease and therefore Z79.4
would not coded because this is what I was taught but got back a screen shot from
Coding Clinic Q3, 2013 which states "Long term use of insulin may also be assigned" for Diabetes Type 1.

 

[thomas7331]

I'm not aware of any new Coding Clinic guidance on this. I agree with you that there is no requirement in the guidelines or instructional notes to code Z79.4 for insulin use with the codes for Type I diabetes as there is for Type 2. However, if the provider has documented insulin dependence as a factor relevant to the encounter, then per the guidelines it should be coded. Also, some organizations may wish this to be captured for reporting purposes if the record shows that the patient is currently using insulin.

 

[8682mu]

I'm not aware of any new Coding Clinic guidance on this. I agree with you that there is no requirement in the guidelines or instructional notes to code Z79.4 for insulin use with the codes for Type I diabetes as there is for Type 2. However, if the provider has documented insulin dependence as a factor relevant to the encounter, then per the guidelines it should be coded. Also, some organizations may wish this to be captured for reporting purposes if the record shows that the patient is currently using insulin.

Thank you

 

[Daymara2019]

Is there an updated coding clinic that says "Not" to code Insulin with Diabetes?
I was audit and got an error for not capturing Z79.4 for patient with Type 1 Diabetes. I disagreed and said
Type 1 Diabetes is an insulin dependent disease and therefore Z79.4
would not coded because this is what I was taught but got back a screen shot from
Coding Clinic Q3, 2013 which states "Long term use of insulin may also be assigned" for Diabetes Type 1.

I've reviewed the Coding Clinic Q3, 2013 and the reason for visit was 'management of diabetes and insulin pump initiation', for wich they suggested assigning a long-term (current) use of insulin code. In 2013, there were still no codes to report the presence of insulin pump (Z96.41) or encounter for adjustment of insulin pump (Z46.81); this group of codes was added in 2016. The clasification has changed so much since 2013 that even the code that the Coding Clinic suggests assigning for Diabetes no longer exists in the ICD-10-CM: Diabetes mellitus without mention of complication, type I [juvenile type], uncontrolled.