Question Z79.4 (HCC 19) with insulin pump status?

ChattRiskCoder

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To all you RA coders out there,

Thoughts on coding long-term insulin Z79.4 (HCC 19) when an insulin pump is included in the documentation as well? Insulin pump status does not have an HCC value. Just wondering how others address this. I have not located any guidelines for this.
 

bcrunk

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I would not code Z79.4 unless an insulin is mentioned somewhere in the note - even if it noted that the patient has an insulin pump.
 

EllaC

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I agree that I would need to see further evidence of insulin use in the medication list or body of the record to capture Z79.4. Could a person with Type II diabetes be dependent on insulin, have a pump put in place, work hard with diet and exercise resulting in control without insulin, and simply not have the pump removed yet? Chances are slim, but never zero.
 
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If they have a pump, they obviously have long term use of insulin or they wouldn't have an insulin pump. If they are DM1, I wouldn't code z79.4, but if they are DM2 I would.
 
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