I assigned code V58.67 on a record for a patient who is type 1 diabetic and using daily insulin injections. I was told this was incorrect. Don’t the coding guidelines say I need to report this code for diabetic patients who are using insulin?
Answer: Updated January 9, 2017
The use of code Z79.4 to indicate long-term current use of insulin is only used for patient’s who are type II diabetic. Some type II diabetics require insulin use to control their blood sugars and others do not. If a type II diabetic is using insulin it is important to report that with a Z code because the use of this medication will affect the physician’s management of the patient. Type I diabetics require the use of insulin to live. The use of insulin is implied in the diagnosis of Type I diabetes itself. Since this is the case, it is not necessary to report a Z code for long-term insulin use because it would be understood that this patient would be using insulin. The coding guideline from chapter 3 that you referred to specifies the use of code Z79.4 where it says, “ For type II patients who routinely use insulin, code Z79.4, Long term (current) use of insulin, should also be assigned to indicate that the patient uses insulin.”