Z96.41 — Presence of insulin pump (external) (internal)
Is Z96.41 billable?
Yes — Z96.41 is billable for FY2027. Z96.41 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z96.41 may be submitted for encounters from October 1, 2026 through September 30, 2027.
Z96.41 at a glance
| Code | Z96.41 |
|---|---|
| Description | Presence of insulin pump (external) (internal) |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to Z96.41?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z96.41 directly.
CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.
Which MS-DRGs does Z96.41 group to?
Z96.41 sits in MDC 23 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 951Other Factors Influencing Health Statusmedical
How is Z96.41 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to Z96.41. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Presence › insulin pump (of)
- Presence › implanted device › insulin pump (of)
Excludes2 — not included here — inherited from Z96
The conditions below are not part of Z96.41, but a patient may have both at the same time. When documentation supports it, Z96.41 and the excluded code may both be reported.
Code also — inherited from Z77-Z99
Two codes may be needed to describe the condition fully. Whether Z96.41 is sequenced first depends on the reason for the encounter.
- any follow-up examination (Z08-Z09)
How long has Z96.41 existed?
Z96.41 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.