Long term current drug use

[momymom1]

When using code Z79.84 (current use of oral hypoglycemic drugs) for a newly diabetic patient who is being prescribed a medication such as metformin, it was my understanding that this code would not be used until they have filled the medication more than once. Am I correct in this logic?

 

[thomas7331]

The official guidelines only say that these codes are assigned for patients "receiving a medication for an extended period ...as treatment of a chronic condition (such as arthritis) or a disease requiring a lengthy course of treatment (such as cancer)" and should not be used "for medication being administered for a brief period of time to treat an acute illness or injury." I'm not aware of any official guidance that defines this more narrowly as being only for patients having filled a prescription more than once, though it's possible that there are some unofficial or organization-specific guidelines that might say this.

As a general rule, though, a coder should only use the treating provider's documentation for code assignment, and I would think that an auditor likely would not consider a review of a patient's prescription history to be proper way to support the decision to assign or not assign any given code.