Z79 › Z79.8 › Z79.81

Z79.818 Long term (current) use of other agents affecting estrogen receptors and estrogen levels

BillableNo payment HCCChapter 21

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Instructional notes

Chapter 21

Notes

Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
(a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
(b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.

Section Z77-Z99

Code also

any follow-up examination (Z08-Z09)

Z79

Excludes2Not included here: the patient may have both; report both when both are present.

drug abuse and dependence (F11-F19)
drug use complicating pregnancy, childbirth, and the puerperium (O99.32-)

Code also

any therapeutic drug level monitoring (Z51.81)

Includes

long term (current) drug use for prophylactic purposes

Z79.81

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.

hormone replacement therapy (Z79.890)

Code firstSequence the underlying condition first.

, if applicable:
malignant neoplasm of breast (C50.-)
malignant neoplasm of prostate (C61)

Use additional codeAdd a second code for the full picture.

code, if applicable, to identify:
estrogen receptor positive status (Z17.0)
family history of breast cancer (Z80.3)
genetic susceptibility to malignant neoplasm (cancer) (Z15.0-)
personal history of breast cancer (Z85.3)
personal history of prostate cancer (Z85.46)
postmenopausal status (Z78.0)

This code

Inclusion terms

Long term (current) use of estrogen receptor downregulators
Long term (current) use of fulvestrant (Faslodex)
Long term (current) use of gonadotropin-releasing hormone (GnRH) agonist
Long term (current) use of goserelin acetate (Zoladex)
Long term (current) use of leuprolide acetate (leuprorelin) (Lupron)
Long term (current) use of megestrol acetate (Megace)

Chapter 21: Factors influencing health status and contact with health services · Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.