2025 ICD-10-CM code Z79.4
Long term (current) use of insulin.
The medical necessity for long-term insulin use is determined by the patient’s underlying condition and the need to maintain blood glucose levels within a target range to prevent acute and chronic complications of diabetes.
The clinician is responsible for evaluating the patient's need for long-term insulin therapy, prescribing the appropriate type and dosage of insulin, monitoring the patient's response to insulin therapy (including glucose levels and any adverse effects), and educating the patient about proper insulin administration, storage, and potential complications.
In simple words: This code indicates that the patient is currently taking insulin as a long-term treatment.
This code indicates the patient is currently using insulin for long-term management of their condition, typically diabetes.
Example 1: A patient with type 1 diabetes requires daily insulin injections to manage their blood sugar levels., A patient with type 2 diabetes, whose blood sugar is not adequately controlled by oral medication and lifestyle changes, is prescribed long-term insulin therapy., A patient with gestational diabetes requires insulin during pregnancy to control blood sugar levels.
Documentation should support the medical necessity for long-term insulin use, including the diagnosis requiring insulin (e.g., type 1 diabetes, type 2 diabetes, gestational diabetes), the type of insulin prescribed, the dosage and frequency of administration, and monitoring of the patient’s response to therapy.
** Excludes2: long-term (current) use of injectable non-insulin antidiabetic drugs (Z79.85) and long-term (current) use of oral antidiabetic drugs (Z79.84).It's always crucial to ensure the documentation supports the medical necessity of the insulin use.
- Specialties:Endocrinology, Internal Medicine, Family Medicine, Primary Care
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Nursing Facility, Home