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Changes Are Coming for Billing Insulin in DME Pumps Under Medicare

Keep this table handy to apply new modifiers JK and JL correctly starting in May. Durable medical equipment (DME) suppliers and pharmacies that provide insulin pumps or insulin for pumps need to be aware of the following key points about upcoming Medicare changes under Part B. Comply With the Coinsurance Cap Starting July 1, 2023, […]

The post Changes Are Coming for Billing Insulin in DME Pumps Under Medicare appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Coding presence of insulin pump


I am struggling to find anything definitive either way… Hoping someone here can point me in the right direction :confused:

(The below example assumes that the visit record does support both codes being discussed.)

When coding the presence of an insulin pump (Z96.41), do you ALSO need to code the insulin use (Z79.4)?

It seems like it would be redundant to include both, and would be likely be determined similarly to when you have BOTH insulin use AND anti-diabetic drugs listed in the record, you code only the insulin use.

But then again, I can see why you may need/want to include both…

I’m SO confused. LOL TIA for your help!! 😎

Medical Billing and Coding Forum

Hypoglycemia status post accidental insulin overdose

a patient with diabetes 2 accidentally took a higher dose of insulin and as a result ended up with hypoglycemia.

So would these be the correct ICD 10 CM codes? I feel I am being redundant but not sure how else I would code it.
T383x1A
E116.49
E16.0

Thank you

Medical Billing and Coding Forum