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The Pamphleteer

Common medications in this class include: Ozempic (semaglutide) Wegovy (semaglutide) Rybelsus (semaglutide) Mounjaro (tirzepatide) Zepbound (tirzepatide) Trulicity (dulaglutide) While many users experience common, milder side effects like nausea, a growing number of individuals are reporting severe, persistent, and life-altering gastrointestinal injuries

Example: Prednisone-induced diabetes, no complications, patient started on insulin: T38.0X5A (adverse effect, glucocorticoids, initial encounter) E09.9 (drug-induced diabetes, no complications) Z79.4 (long-term insulin use) Example: Steroid-induced diabetes with polyneuropathy: T38.0X5A E09.42 (drug-induced diabetes with polyneuropathy) Z79.4 (if on insulin) The Most Common Error Here Defaulting to E11 because the patient is a new diabetic. If steroids caused the diabetes, E09 is always correct regardless of the patients age, weight, or family history

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Thinking about GLP-1

Evidence-Based Alternatives to Combination Therapy When a patient does not achieve desired results on monotherapy, clinical evidence supports dose optimization, extended treatment duration, and lifestyle integration rather than adding a second agent