Breakdown (mechanical) of insulin pump, subsequent encounter

This code signifies a mechanical malfunction or failure of an implanted or external insulin pump that has been previously placed. It indicates that the device itself has experienced a breakdown, rather than a problem with the insulin reservoir or tubing. This is specifically for a subsequent encounter, meaning the patient is returning for follow-up care related to the initial pump breakdown.

Use this code when a patient presents for evaluation, repair, or replacement of an insulin pump due to a mechanical issue, and this is not their initial visit for this specific problem. This applies to situations where the pump's internal components, motor, or housing have failed. It would be appropriate for follow-up appointments after an initial diagnosis of pump breakdown, or for ongoing management of the issue.

• Ensure documentation clearly specifies a mechanical breakdown of the pump itself, not just a supply issue.
• Verify this is a subsequent encounter; an initial encounter for the same breakdown would use a different seventh character.
• Pair with an external cause code (V00-Y99) if the breakdown was due to an external event, such as a fall or impact.