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Home/Diagnosis/ICD-10 Coding for Metformin Use in Diabetes

ICD-10 Coding for Metformin Use in Diabetes

E11.9
Z79.84

Complete ICD-10-CM coding and documentation guide for icd-10 coding for metformin use in diabetes includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Glucophage
Oral Hypoglycemic Therapy
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Key Information: ICD-10 Coding for Metformin Use in Diabetes

Essential facts and insights about ICD-10 Coding for Metformin Use in Diabetes

Use ICD-10 code E11.9 for type 2 diabetes mellitus without complications, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Type 2 diabetes mellitus without complications

Billable Code
E11.9
Billable

Diagnostic Criteria

clinical_criteria:
  • • Patient has type 2 diabetes without complications.
applicable_to:
  • • Type 2 diabetes
  • • Non-insulin-dependent diabetes
excludes:
  • • Type 1 diabetes (E10.-)
validation:
  • • HbA1c ≥6.5%
  • • Fasting glucose ≥126 mg/dL

Important Notes

  • • Ensure explicit documentation of diabetes management with metformin.

Long-term (current) use of oral hypoglycemic drugs

Billable Code
Z79.84
Billable

Diagnostic Criteria

applicable_to:
  • • Long-term use of metformin
validation:
  • • Documentation of long-term metformin use

Important Notes

  • • Ensure it follows the primary diabetes code in sequencing.
Ancillary Codes

Additional codes that may be used with this diagnosis

Z79.84

Long-term (current) use of oral hypoglycemic drugs

Use alongside E11.9 to indicate ongoing metformin therapy.

Frequently Asked Questions

What is the ICD-10 code for metformin use?

The ICD-10 code for long-term use of metformin is Z79.84, used alongside a primary diabetes code like E11.9.

How do you code metformin for type 2 diabetes?

For type 2 diabetes managed with metformin, use E11.9 for the diabetes and Z79.84 for the long-term metformin use.

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