Z79.61 — Long term (current) use of immunomodulator
Z79.61 is a billable, specific ICD-10-CM code for long term (current) use of immunomodulator. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Long term (current) use of apremilast
- Long term (current) use of immunomodulatory imide drug
- Long term (current) use of lenalidomide
- Long term (current) use of pomalidomide
Risk adjustment
Z79.61 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
Z79.61 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57206Billing and Coding: Lumbar MRI
- A57718Billing and Coding: Vitamin D Assay Testing
How Z79.61 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Z79.61.
- Long-term›apremilast
- Long-term›immunomodulatory imide drug
- Long-term›lenalidomide
- Long-term›pomalidomide
Related codes at this level
Codes that share Z79.6. If Z79.61 is not quite right, the correct code is usually one of these.
- Z79.60Long term (current) use of unspecified immunomodulators and immunosuppressants
- Z79.62Long term (current) use of immunosuppressant
- Z79.63Long term (current) use of chemotherapeutic agent
- Z79.64Long term (current) use of myelosuppressive agent
- Z79.69Long term (current) use of other immunomodulators and immunosuppressants
Questions about Z79.61
- Is Z79.61 a billable ICD-10-CM code?
- Yes. Z79.61 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Z79.61 sit in the tabular list?
- Factors influencing health status and contact with health services (Z00-Z99), in the block Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).