ICD-10-CM Code for Other mechanical complication of insulin pump T85. 694.
An underdose of insulin due to an insulin pump failure can be reported using code from subcategory T85. 6 that specifies the type of pump malfunction, as the principal or first-listed code, followed by code T38. 3X6.
Breakdown (mechanical) of insulin pump, initial encounter T85. 614A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM T85. 614A became effective on October 1, 2021.
ICD-10 Code Z79. 4, Long-term (current) use of insulin should be assigned to indicate that the patient uses insulin for Type 2 diabetes mellitus (Category E11* codes).
CPT Code 99091 The Endocrine Society has verified that insulin pump data is considered physiologic data and its review and analysis is covered by this service.
Type 2 diabetes mellitus ICD-10-CM E11. 649 is grouped within Diagnostic Related Group(s) (MS-DRG v39.0):
Type 2 diabetes mellitus with other circulatory complicationsICD-10 Code for Type 2 diabetes mellitus with other circulatory complications- E11. 59- Codify by AAPC.
Type 2 diabetes mellitus with unspecified complications E11. 8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM E11. 8 became effective on October 1, 2021.
ICD-10-CM Code for Type 2 diabetes mellitus with other specified complication E11. 69.
84 for Long term (current) use of oral hypoglycemic drugs is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
E13, Other specified diabetes mellitus. Includes: Diabetes mellitus due to genetic defects of beta-cell function. Diabetes mellitus due to genetic defects in insulin action.
Codes.
T38. 3X1A - Poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, accidental (unintentional) [initial encounter]. ICD-10-CM.
In one survey of 640 new pumps from four different insulin pump manufacturers, 36% were reported to have a defect of some sort including 16% that had failed and 6.5% that required replacement due to a mechanical defect (27,28).
ICD-10 code E11. 1 for Type 2 diabetes mellitus with ketoacidosis is a medical classification as listed by WHO under the range - Endocrine, nutritional and metabolic diseases .
Hypoglycemia is abnormally low levels of blood glucose (lower than 70 milligrams per deciliter). Hyperglycemia is abnormally high levels of blood glucose (fasting plasma glucose ≥126 milligrams per deciliter on two separate tests). Hypoglycemia can cause confusion, seizures, coma, and even death.
996.57 - Mechanical complication; due to insulin pump . Select this code to report mechanical failure of an insulin pump, a device used by diabetics that injects insulin into the bloodstream and intervals to regulate blood sugar levels.
Thus the code 996.57, Mechanical complication due to insulin pump tells there was a problem with the pump not administering the med, and code 250.1* Diabetes with ketoacidosis tells what it resulted in.
An E code is usually used in the case of poisoning or an overdose. But this does not fall under overdose. This is an underdose if the "pump failed to deliver insulin, causing ketoacidosis.
Think of ICD-10 as making you a better coder because you will have better tools/codes to work with.
So, as far as it looks, neither incident requires an E code.
Normally, you will code the diabetes first, but in this case, the patient was getting diabetic ketoacidosis due to the fact that the insulin pump was malfunctioning and wasn't getting the insulin to the patient. Therefore, you will have to code the insulin pump malfunction first, with the diabetes with ketoacodosis second.