This page addresses follow-up questions and additional information pertinent to our webinar
ICD-10 Coding Updates Q1 2026: Beyond the Headlines.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic, as they can change rapidly.
Q: The indexing for diabetic peripheral neuropathy seems inconsistent. What is the correct code to assign?
A: You are correct—the indexing for diabetic peripheral neuropathy can be inconsistent. Depending on whether you search under the main term Diabetes or Neuropathy, you may be directed to different codes.
At Haugen, after internal review and discussion, we recommend assigning a code from categories E08–E11 with the fourth and fifth characters .42, which corresponds to diabetic polyneuropathy. This approach provides the most consistent and clinically appropriate coding. Due to the inconsistency in indexing, the question has been submitted to Coding Clinic for official guidance, but in the meantime, we recommend using the code for polyneuropathy when neuropathy is specified as peripheral. This is because the entry “Neuropathy; peripheral” refers to Polyneuropathy (in the Index).
Q: When a patient has a stenosis of a coronary bypass graft and code T82.857A (Stenosis of other cardiac prosthetic devices, implants, and grafts) is assigned, should a code also be assigned for CAD of the saphenous vein graft?
A: No. According to Coding Clinic, 1st Quarter 2026, stenosis of a coronary artery bypass graft or stent should be coded as a complication, rather than as coronary artery disease (CAD). A code for CAD of the graft should not be assigned unless the provider specifically documents that the stenosis represents a progression of the underlying CAD. In the absence of such documentation, the condition is classified as a complication of the graft or stent, and coding should reflect that distinction.
A: Yes. While I.A.15 assumes a causal relationship when two conditions are linked by the words “with” or “in” in the index, there are important exceptions. Certain conditions require explicit provider documentation to establish a link. For example, in cases such as sepsis with acute organ dysfunction, official guidelines require the provider to clearly document the relationship before it can be coded as related.
Q: What about dementia associated with other conditions, such as epilepsy?
A: In some cases, there may not be a specific guideline outlining the exception. However, Coding Clinic advice – which is considered official coding guidance – may override the default assumption in I.A.15. For example, Coding Clinic provides direction that the provider must establish a link between dementia and epilepsy, even though the two conditions are linked by the word “in” in the index (Source: Coding Clinic, 1st Quarter 2026).
Q: How can coders practically apply this in day-to-day coding?
A: Coders should:
• Start with guideline I.A.15 as the default approach
• Check for any applicable guidelines that require a documented relationship
• Review Coding Clinic guidance for known exceptions
Additionally, many encoder software systems incorporate Coding Clinic logic and may provide prompts or alerts. Coders are encouraged to review any hints, tips, or references provided in their encoder to ensure the accurate application of the guidelines.
Q: Should code Z79.899 be reported with diabetes codes when a patient is using injectable non-insulin antidiabetic medications?
A: Instructional notes for categories E08–E09 and E11–E13 direct coders to assign Z79.85 for the use of injectable non-insulin antidiabetic drugs. However, there is no corresponding note instructing the use of Z79.899 for long-term use of other medications. Despite the absence of a “use additional code” note, Haugen recommends assigning Z79.899 as a best practice when documentation supports the long-term use of an injectable medication, such as a GLP-1 receptor agonist (e.g., Ozempic). This approach helps more fully capture the patient’s ongoing medication therapy.
Q: Is this recommendation based on official coding guidance?
A: No. This is considered a Haugen best practice, rather than formal Coding Clinic or guideline-driven instruction. The recommendation is intended to enhance specificity and provide a more complete clinical picture.
Q: Why is Z79.899 recommended in these cases?
A: Assigning Z79.899 helps identify the patient’s continued use of injectable medications that may not yet have a dedicated long-term use code. Until a more specific code is developed, this approach supports more accurate reporting of medication therapy.
Q: Are there plans for a more specific code for GLP-1 medications?
A: As of March 2026, there have been no formal proposals presented to the Coordination and Maintenance Committee for a dedicated code addressing long-term use of GLP-1 medications. However, it is possible that future updates – potentially informed by internal Coding Clinic review – may address this gap.
Meet the Presenter: Kristi Pollard, RHIT, CCS, CPC, CIRCC
Kristi is the Director of Coding Quality & Education with more than 25 years of industry experience; she is responsible for the development of web-based, instructor-led, and webinar training materials; conducting training in ICD-10-CM/PCS and CPT; and performing DRG and APC audits. Kristi has an extensive background in coding education and consulting and is a national speaker and published writer on topics related to ICD-10 and CPT coding and code-based reimbursement. She has designed and developed training programs for inpatient and outpatient hospital-based coding, with a focus on vascular interventional radiology, interventional cardiology, orthopedics, and obstetrics.
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