Do You Know When to Code Z79.4?

on Tuesday, 25 September 2018. All News Items | Miscellaneous | Coding

A few weeks ago, we had an article about ICD-10 diagnosis code Z79.84 “long-term use of an oral anti-diabetic drug”. One of the challenges in using this code is that coders don’t always know which drugs are classified as an anti-diabetic drug, so they don’t know to pick it up.

I have recently come across a similar problem knowing when to use diagnosis code Z79.4 “long-term use of insulin” because there are so many different types of insulin on the market today, and I don’t always recognize them as being Insulin when I see the drug name.

Back in the 1980s when I was working as a bedside nurse, we only had Regular Insulin and NPH insulin. We never had to think about specific brand names. I know – that was several years ago, so, before you ask, I will go ahead and tell you, “No, we did not have to sharpen our own needles”.

As coders in the 21st century, we do have to give this some thought if we are going to follow diabetes coding guidelines which state:  When E11- is reported for type 2 diabetes, use an additional code to identify control using insulin.

Below is an alphabetical list of the more common insulin names and types. You may want to keep the list handy in case you see one of these drugs in your patient’s record, so you will have a better idea when Z79.4 should be reported in addition to the E11- diabetes. Click here to see more information on the drug.com website.

ActRapid
Admelog
Afrezza (inhaled insulin)
Apidra
Aspart
Basaglar
Degludec
Detemir
Exubera
Fiasp
Glargine
Glulisine
Humalog
Humulin
Iletin
Lantus
Lantus Solostar
Levemir
Lispro
NovoLog
NPH
Relion
Ryzodeg
Toujeo
Tresiba
Velosulin

Article by Jeff Gordon

Jeff Gordon, RN, MSN, CCA, COC is the Manager of Outpatient Medical Review at Medical Management Plus, Inc. Jeff has over thirty-five years of experience in healthcare including Critical Care, Infection Control, Quality Assurance, Medical Necessity, Outpatient Coding, Medicare Claims data analysis and Medical Record review.

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