Long-term insulin & insulin pump

mcdream

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Question #1: Insulin pump is long-term insulin use & per guidelines you only code for the insulin pump Z96.41?
Question #2: Insulin pump Z96.41 does not risk adjust (no HCC), but long-term insulin Z79.4 does risk adjust (HCC 19)?
Question #3: Diabetic on long-term insulin via pump does not risk adjust, but a diabetic on long-term insulin without an insulin pump does risk adjust (HCC19)?
 

jmulis

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see responses below (caveat: I recently earned my CRC but have no work experience in risk adjustment coding)
Question #1: Insulin pump is long-term insulin use & per guidelines you only code for the insulin pump Z96.41?
----I don't see anything in the guidelines that prevent you from coding both and there is no Excludes note in the book. I would have assumed you couldn't code both but I don't see anything that prevents it.
Question #2: Insulin pump Z96.41 does not risk adjust (no HCC), but long-term insulin Z79.4 does risk adjust (HCC 19)?
----correct
Question #3: Diabetic on long-term insulin via pump does not risk adjust, but a diabetic on long-term insulin without an insulin pump does risk adjust (HCC19)?
----I assume if you can code both the pump and the long term insulin use, both scenarios risk adjust.
 
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