Z79.4
Z79.4: Long term (current) use of insulin
Billable / specific codeICD-10-CMPOA exempt
Z79.4 is a billable, specific ICD-10-CM code for long term (current) use of insulin. It is valid for submission on a claim.
Check Z79.4 with the rest of the claim: free scrubberExcludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Risk adjustment
Z79.4 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 38 Diabetes with No, Glycemic, or Unspecified Complications0.166 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
Z79.4 is named in 14 Medicare coverage policies: 14 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56551Billing and Coding: Visual Fields Testing
- A56674Billing and Coding: Home Health Plans of Care: Monitoring Glucose Control in the Medicare Home Health Population with Type II Diabetes Mellitus
- A56799Billing and Coding: Visual Fields Testing
- A57189Billing and Coding: Serum Magnesium
Alphabetic index entries that lead here
- Long-term›insulin
- Therapy›drug, long-term›insulin
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under Z79
- Z79.0Long term (current) use of anticoagulants and antithrombotics/antiplatelets
- Z79.1Long term (current) use of non-steroidal anti-inflammatories (NSAID)
- Z79.2Long term (current) use of antibiotics
- Z79.3Long term (current) use of hormonal contraceptives
- Z79.5Long term (current) use of steroids
- Z79.6Long term (current) use of immunomodulators and immunosuppressants
- Z79.8Other long term (current) drug therapy