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BETA v.3.0

2025 ICD-10-CM code Z46.81

Encounter for fitting and adjustment of insulin pump.

A corresponding procedure code must accompany a Z code if a procedure is performed.Use Z codes as a secondary code to indicate the reason for the encounter.

Medical necessity for the fitting and adjustment of an insulin pump should be documented. This typically includes the patient's diagnosis of diabetes, the need for insulin therapy, and the rationale for using an insulin pump over other methods of insulin delivery.

The clinician is responsible for ensuring the proper fitting and adjustment of the insulin pump to meet the patient's individual needs. This includes programming the device, educating the patient on its use, and monitoring for any complications.

In simple words: This code is used when a patient visits a healthcare professional to have their insulin pump fitted or adjusted.

Encounter for fitting and adjustment of insulin pump. This code is used for encounters with health services for the fitting and adjustment of an insulin pump.

Example 1: A patient with type 1 diabetes visits their endocrinologist to have their insulin pump fitted and adjusted., A patient with type 2 diabetes who is starting insulin pump therapy visits a diabetes educator for training and pump fitting., A patient with an existing insulin pump visits their healthcare provider for adjustments due to changes in their insulin needs.

Documentation should include the type of insulin pump, the settings programmed into the device, any patient education provided, and any complications encountered.

** This code is specifically for the fitting and adjustment of insulin pumps. For training and instruction on insulin pump use, use Z71.3, and for insulin pump titration, use Z51.81.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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