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Here, our Chief Executive Officer, Katrina Burchell breaks down the legal and clinical reasons behind the current classification and highlights the crucial work being done by the Pernicious Anaemia Society to improve care

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These molecules support intestinal integrity and influence metabolic signaling pathways involved in insulin sensitivity and appetite control

In preclinical models its reported effects concentrate at or near the site of administration, where it appears to promote new vessel formation, support fibroblast activity and stabilise the local healing environment

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Administration Codes: CPT 96372 - Therapeutic/prophylactic/diagnostic injection, subcutaneous or intramuscular (in-office administration) Modifier 59/XS - For additional separate injections on same date Modifier 25 - On E/M code when separate E/M service performed same day as injection Drug Codes (HCPCS): J3490 - Unclassified drugs (primary code for tirzepatide in physician office) C9399 - Unclassified drugs or biologicals (hospital outpatient setting) J3590 - Unclassified biologics (alternative, less commonly used) J3420 - Injection, vitamin B-12 cyanocobalamin, up to 1000 mcg (when B12 billed separately) Diabetes Diagnosis Codes (Mounjaro): E11.65 - Type 2 diabetes with hyperglycemia (strongest for medical necessity) E11.9 - Type 2 diabetes without complications E11.21 - Type 2 diabetes with diabetic nephropathy E11.40 - Type 2 diabetes with diabetic neuropathy Z79.85 - Long-term (current) use of injectable non-insulin antidiabetic drugs Obesity Diagnosis Codes (Zepbound): E66.01 - Morbid (severe) obesity due to excess calories E66.09 - Other obesity due to excess calories E66.3 - Overweight Z68.30-Z68.45 - BMI codes (required supplemental codes) Common Comorbidity Codes: I10 - Essential hypertension E78.5 - Hyperlipidemia, unspecified G47.33 - Obstructive sleep apnea K76.0 - Fatty liver, not elsewhere classified (NAFLD) M19.90 - Unspecified osteoarthritis E/M Codes: 99203-99205 - New patient office visits 99213-99215 - Established patient office visits G0447 - Face-to-face behavioral counseling for obesity, 15 min (Medicare) Counseling and Therapy Codes: 99401-99404 - Preventive medicine counseling 97802 - Medical nutrition therapy, initial assessment 97803 - Medical nutrition therapy, reassessment This reference table covers the vast majority of coding scenarios for tirzepatide