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Introduction Metformin is commonly used in the treatment of type 2 diabetes and improves insulin sensitization and glucose metabolism [1]

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MS patients with diabetes should be counseled on hypoglycemia recognition, which may be challenging if autonomic neuropathy or cognitive impairment is present

Critical supporting codes that should accompany the E66 primary diagnosis include: Z68.30 through Z68.45 - BMI codes specifying the exact range (Z68.35 = BMI 35.0-35.9, Z68.41 = BMI 41.0-44.9, etc.) I10 - Essential hypertension (a qualifying comorbidity) E78.5 - Hyperlipidemia, unspecified (another qualifying comorbidity) G47.33 - Obstructive sleep apnea (a qualifying comorbidity) E11.9 - Type 2 diabetes (if present as comorbidity) Loading the claim with all applicable comorbidity codes significantly improves the chances of first-pass approval