Guidelines › Insulin pump malfunction

Insulin pump malfunction

Official text from the FY2027 ICD-10-CM Official Guidelines for Coding and Reporting. The wording is quoted exactly.

Guidelines I.C.4.a.5

“An underdose of insulin due to an insulin pump failure should be assigned to a code from subcategory T85.6, Mechanical complication of other specified internal and external prosthetic devices, implants and grafts, that specifies the type of pump malfunction, as the principal or first-listed code, followed by code T38.3X6-, Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs.”

“Additional codes for the type of diabetes mellitus and any associated complications due to the underdosing should also be assigned.”

Where this applies

96 billable codes. Source: FY 2027 ICD-10-CM Official Guidelines for Coding and Reporting, effective October 1, 2026. Full Guidelines (PDF, CMS)

The Guidelines are the authority for assigning codes, and following them is required under HIPAA. This page quotes them for convenience and is not a substitute for the official document. See the Terms and Disclaimer.