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ICD-10 Coding for Semaglutide: Long-Term Use, Overdose, Allergies & Adverse Effects

Semaglutide is a newer type 2 diabetes medication that helps lower blood glucose levels. This injectable drug does not have its own specific ICD-10 code yet. Instead, the ICD-10 code used to identify long-term semaglutide use is Z79.899. This falls under the Z79 category for ongoing drug therapy. 

For adverse effects, the codes T46.5X5 plus Z79.899 provide details on semaglutide reactions. Overdose is coded as T45.615A for initial encounters or T45.615D for subsequent care. The CPT code J3490 is used for provider billing of semaglutide injections. 

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What is the ICD 10 code for semaglutide?

The ICD-10 code used to identify semaglutide as the current long-term antihyperglycemic medication is Z79.899. This code falls under the Z79 category for "long term (current) drug therapy." 

According to our research, Z79.899 is the appropriate ICD-10 code for documenting the routine use of semaglutide in patients with diabetes. This lets providers specifically indicate semaglutide, rather than a more general diabetes medication code, for clear documentation and billing purposes. 

Per medical coding guidelines, Z79.899 should be listed secondary to the primary diabetes diagnosis code, such as E11.9 for type 2 diabetes without complications

What is the ICD 10 CM code for semaglutide?

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The ICD-10-CM code for identifying long-term semaglutide use is also Z79.899. ICD-10-CM refers to the clinical modification of ICD-10 codes used in the United States. While other countries may use variations of ICD-10, Z79.899 is the official semaglutide code in ICD-10-CM for domestic medical billing and documentation.

It offers the highest level of specificity for semaglutide therapy over other diabetes medication codes. For providers in the U.S. prescribing semaglutide, it is essential to understand the proper ICD-10-CM coding to ensure accuracy. 

Based on our knowledge, Z79.899 remains the most specific code to convey that a patient is regularly taking semaglutide.

What is the ICD 10 code for semaglutide overdose?

For documenting semaglutide overdose, the ICD-10 codes used will depend on whether it is accidental versus intentional and the encounter. Specifically:

  • T45.615A is the ICD-10 code for accidental (unintentional) poisoning by antidiabetic drugs, initial encounter. According to our research, this code covers the initial treatment for semaglutide overdose.
  • T45.615D is the appropriate code for subsequent encounters, indicating follow-up care.
  • T45.615S would be used for coding sequela of antidiabetic drug poisoning.

Overall, these T45.615 codes offer a way to precisely document semaglutide toxicity and overdose for accurate record-keeping. The encounter character provides additional specificity. As always, proper coding is essential for conveying the details of the clinical situation.

What is the ICD 10 code for an allergy to semaglutide?

For documenting a semaglutide allergy, the ICD-10 code is Z88.0, for allergy to drugs, medicaments, and biological substances. However, Z88.0 is very broad. Based on our experience, it is best practice to also include the code Z79.899 to specify the semaglutide allergy. 

The combination of Z88.0 plus Z79.899 codes offers the most detail for identifying a semaglutide allergy in the medical record and claims data. Proper ICD-10 coding provides precision, which is important for managing medication allergies long-term and avoiding adverse reactions

According to our knowledge, the codes Z88.0 and Z79.899 together convey the clearest picture.

What is the ICD 10 code for adverse effects of semaglutide?

The ICD-10 codes for documenting adverse effects of correctly administered semaglutide are in the T36-T50 series. Specifically, the code T46.5X5 covers adverse effects of "other antidiabetic drugs." 

To specify the semaglutide adverse reaction, our advice is to also include the supplemental Z79.899 code for its long-term use. This pinpoints semaglutide as the cause versus other antidiabetic agents. 

Some examples of semaglutide side effects include nausea, vomiting, diarrhea, and constipation based on clinical trials. Proper coding of adverse drug reactions can improve pharmacovigilance and medical management. 

Overall, the combination of T46.5X5 plus Z79.899 codes provides the best documentation of semaglutide adverse effects.

What is the ICD 10 code for long-term use of semaglutide?

The ICD-10 code for documenting long-term or current semaglutide use in diabetes management is Z79.899. This code specifically identifies semaglutide as the antihyperglycemic agent, rather than a broader class. 

Based on our experience, Z79.899 should be used in patients taking semaglutide regularly for type 2 diabetes, as it offers more precision than a general diabetes code. This is important for capturing medication details for medical records, population health data, and claims. 

Proper ICD-10 coding also helps demonstrate adherence if semaglutide is prescribed long-term. In summary, Z79.899 is the most specific code to convey ongoing semaglutide therapy for diabetes or weight loss.

What is the CPT code for semaglutide injections?

The CPT code for injectable semaglutide is J3490. J3490 is also the appropriate CPT code for billing semaglutide injections in a provider's office. This code falls under the broader J3490-J9999 category for "Unclassified Drugs."

Specifically, J3490 is used for injectable prescription drugs that do not have their own unique CPT code yet. As a newer medication, semaglutide shots would be billed under J3490.

The use of J3490 requires listing the name of the drug - semaglutide in this case. This helps provide details for billing and reimbursement purposes.

Proper CPT coding is essential for conveying the specific medication administered and ensuring accurate payment. Based on our experience, J3490 is the appropriate code providers should use when giving semaglutide injections in the office setting.

Conclusion

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Newer drugs like semaglutide do not have specific ICD-10 codes. Documentation depends on using broader codes plus naming the drug. Correct coding is still vital for record-keeping, analysis, and billing accuracy. As semaglutide use increases, more precise codes may develop to capture its nuances.

Here at Dr. V Medical Aesthetics, we provide personalized semaglutide weight loss plans including injections, lab work, IV vitamin therapy, and regular checkups. Our experienced providers develop customized programs to help patients achieve their goals safely. 

Contact us today to learn more about our non-surgical medical weight loss options and find out if semaglutide is right for you. We're here to help support your wellness journey.

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