Z79.81

Z79.81: Long term (current) use of agents affecting estrogen receptors and estrogen levels

Non-billable headerICD-10-CM

Z79.81 is a non-billable header ICD-10-CM code for long term (current) use of agents affecting estrogen receptors and estrogen levels. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

hormone replacement therapy (Z79.890)

Code first

The underlying condition must be sequenced before this code.

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

Use additional code

Add a secondary code to capture the detail described below.

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)

Excludes2 inherited from the categories above Z79.81

Not part of this code, but both may be coded when both are present.

Written on Z79: Long term (current) drug therapy

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

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead Z79.81

3 child codes. Green means billable.