Insulin Pump Failures

An underdose of insulin due to an insulin pump failure is assigned using a code from subcategory T85.6, “Mechanical complication of other specified internal and external prosthetic devices, implants and grafts” as the principal or first-listed code, followed by code T38.3X6- “Underdosing of insulin and oral hypoglycemic drugs.” Additional codes for the type of diabetes mellitus and any associated complications associated with the underdosing are also reported.

As per the ICD-10-CM guideline, I.C.4.a.5.a, “The principal or first-listed code for an encounter due to an insulin pump malfunction resulting in an overdose of insulin, should also be T85.6-, Mechanical complication of other specified internal and external prosthetic devices, implants and grafts, followed by code T38.3X1-, Poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, accidental (unintentional).”