Cracking the Code

Insulin Pump Malfunction Sequencing Guidance

The coding guidelines provide specific guidance on how to accurately report complications of diabetes mellitus due to insulin pump malfunction. For an underdose of insulin due to insulin pump failure, a diagnosis from subcategory T85.6, mechanical complication of other specified internal and external prosthetic devices, implants, and grafts should be sequenced as the principal diagnosis followed by code T38.3X6-, underdosing of insulin and oral hypoglycemic [antidiabetic] drugs as a secondary diagnosis. It is appropriate to assign additional diagnoses for the type of diabetes and any associated complications due to the underdosing as well. For an overdose of insulin due to insulin pump failure, a diagnosis from T85.6 should be reported as the principal diagnosis as well followed by code T38.3X1-, poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, accidental (unintentional).

Reference: References: ICD-10-CM Official Guidelines for Coding and Reporting FY 2021 Section I.C.4.a.5 and AHA Coding Clinic Fourth Quarter 2016 pages 71-72: Complications of other internal prosthetic devices, implants, and grafts
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