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BETA v.3.0

2025 ICD-10-CM code Z96.41

Presence of an insulin pump (internal or external).

Z codes are used to report factors influencing health status and contact with health services.A corresponding procedure code must accompany a Z code if a procedure is performed during the encounter. Use additional codes as needed to fully describe the patient's condition and treatment plan.

Medical necessity is established by the diagnosis of diabetes and the documented use of an insulin pump as part of the patient's treatment plan.

Clinicians should document the type of insulin pump (internal or external), any complications, and any additional diabetes-related information.The code should be used in conjunction with diabetes and other relevant codes.

IMPORTANT:Do not use Z96.41 for complications (T85.6-), fitting/adjustment (Z46.81) of insulin pumps. Use additional codes for diabetes type, control, and other complications.If the patient is treated with an insulin pump and other diabetes medications, other Z codes may be necessary (e.g., Z79.4 for insulin, Z79.84 for oral hypoglycemics, Z79.85 for injectables).

In simple words: This code signifies that the patient has an insulin pump.

This code indicates the presence of either an internal or an external insulin pump, and is used to track patients using this technology for diabetes management.It is not used to code complications of insulin pump use or the fitting/adjustment of the device, which have separate codes.

Example 1: A patient with type 1 diabetes managed with an external insulin pump presents for a routine check-up. Z96.41 is coded along with the appropriate diabetes code (E10.-)., A patient with type 2 diabetes has an insulin pump inserted. The procedure for insertion would be coded, and Z96.41 would be used on subsequent encounters to indicate the presence of the pump., A patient with an insulin pump experiences a malfunction requiring pump replacement. The replacement procedure is coded, and Z96.41 remains valid.

Documentation should specify the type of insulin pump (internal or external). Additional documentation regarding the patient's diabetes type, control, complications, and other treatments should also be included.

  • Specialties:Endocrinology, Internal Medicine, Family Medicine, Pediatrics (for type 1 diabetes), Diabetes Education
  • Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Home Health, Nursing Facility
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