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Z79.818 ICD-10-CM Code: Long term (current) use of other agents affecting estrogen receptors and estrogen levels

Compare with another code for Z79.818Check this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Code firstfrom Z79.81Sequence the underlying condition before this code
  • Code first, if applicable:
  • malignant neoplasm of breast (C50.-)
  • malignant neoplasm of prostate (C61)
Use additional codefrom Z79.81Report with this code when documented
  • Use additional 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-)

+3 more in Instructions

Excludes1from Z79.81Not reported with this code unless documented as unrelated
  • hormone replacement therapy (Z79.890)
Code alsoMay be needed with this code
  • any therapeutic drug level monitoring (Z51.81) (from Z79)
  • any follow-up examination (Z08-Z09) (from Z77-Z99)
Excludes2from Z79Not included here; may be reported together
  • drug abuse and dependence (F11-F19)
  • drug use complicating pregnancy, childbirth, and the puerperium (O99.32-)
IncludesWhat this code covers
  • long term (current) drug use for prophylactic purposes (from Z79)
  • 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

+3 more in Instructions

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Z79.818 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on Z79.818 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • long term (current) drug use for prophylactic purposes

Source: inherited from Z79

Inclusion Terms

Alternative terms the tabular list files under this code.

  • 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)

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from Z79.81

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from Z79

Code First

Underlying conditions that must be sequenced before this code.

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

Source: inherited from Z79.81

Code Also

Additional codes that may be required to fully describe the encounter.

  • any therapeutic drug level monitoring (Z51.81) inherited from Z79
  • any follow-up examination (Z08-Z09) inherited from Z77-Z99

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional 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)

Source: inherited from Z79.81

Coder workflow for Z79.818

MedCoder structured workflow — derived from this code’s own official record

Before you code Z79.818

  1. Confirm the reason for the encounter this Z code records: a status — a condition, carrier state or sequela that may affect care, distinct from a current complication of it. Check whether the code may be reported as first-listed or principal — some Z codes are limited to one position — and do not report a history or status code for a condition documented as current. Z code categories and their reporting positions (Guidelines I.C.21.c.3, I.C.21.c.15).

    Guide: Status codes (Z codes) →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with Z79.818. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in Z79.818’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewZ79.890

  2. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then Z79.818.
    No → Continue; do not add an underlying condition the record does not document.

    ReviewC50, C61

Consider Z79.818. Then work the Use Additional Code note and review the Code Also note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
The reason for the encounter
Whether the code records the encounter’s purpose, a status, or a history — and whether it may be first-listed (Guidelines I.C.21.c).

Official instructions as workflow

  • Excludes1 — check before selecting Z79.818(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with Z79.818: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareZ79.890

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of Z79.818(2 notes)

    Coding workflow: The conditions named in this note are not included in Z79.818. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareO99.32

    See the official tabular notes · Guidelines I.A.12.b

  • Code First — sequencing check(3 notes)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before Z79.818. Do not add an underlying condition the record does not document.

    ReviewC50, C61

    See the official tabular notes · Guidelines I.A.13

  • Use Additional Code — after identifying Z79.818(7 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with Z79.818 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewZ17.0, Z80.3, Z15.0, Z85.3, Z85.46, Z78.0

    See the official tabular notes · Guidelines I.A.13

  • Code Also — related condition(2 notes)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewZ51.81

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition Z79.818 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewZ79.890

Documentation: The underlying condition the Code First note names is documented alongside this condition.

Coding question: How are the two sequenced?

Path: Review the Code First note.

Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).

ReviewC50, C61

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with Z79.818?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewZ17.0, Z80.3, Z15.0, Z85.3, Z85.46, Z78.0

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Long term (current) use of other agents affecting estrogen receptors and estrogen levels is a billable ICD-10-CM diagnosis code (Z79.818).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00 -E89)

3) Diabetes mellitus and the use of insulin, oral hypoglycemics, and injectable non-insulin drugs If the documentation in a medical record does not indicate the type of diabetes but does indicate that the patient uses insulin, code E11-, Type 2 diabetes mellitus, should be assigned. Additional code(s) should be assigned from category Z79 to identify the long-term (current) use of insulin, oral hypoglycemic drugs, or injectable non-insulin antidiabetic, as follows: If the patient is treated with both oral hypoglycemic drugs and insulin, both code Z79.4, Long term (current) use of insulin, and code Z79.84, Long term (current) use of oral hypoglycemic drugs, should be assigned. If the patient is treated with both insulin and an injectable non-insulin antidiabetic drug, assign codes Z79.4, Long term (current) use of insulin, and Z79.85, Long-term (current) use of injectable non-insulin antidiabetic drugs. If the patient is treated with both oral hypoglycemic drugs and an injectable non-insulin antidiabetic drug, assign codes Z79.84, Long term (current) use of oral hypoglycemic drugs, and Z79.85, Long-term (current) use of injectable non-insulin antidiabetic drugs. Code Z79.4 should not be assigned if insulin is given temporarily to bring a type 2 patient’s blood sugar under control during an encounter.

Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00 -E89)

(a) Secondary diabetes mellitus and the use of insulin, oral hypoglycemic drugs, or injectable non-insulin drugs For patients with secondary diabetes mellitus who routinely use insulin, oral hypoglycemic drugs, or injectable non-insulin drugs, additional code(s) from category Z79 should be assigned to identify the long-term (current) use of insulin, oral hypoglycemic drugs, or non-injectable non-insulin drugs as follows: If the patient is treated with both oral hypoglycemic drugs and insulin, both code Z79.4, Long term (current) use of insulin, and code Z79.84, Long term (current) use of oral hypoglycemic drugs, should be assigned. If the patient is treated with both insulin and an injectable non- insulin antidiabetic drug, assign codes Z79.4, Long- term (current) use of insulin, and Z79.85, Long-term (current) use of injectable non-insulin antidiabetic drugs. If the patient is treated with both oral hypoglycemic drugs and an injectable non-insulin antidiabetic drug, assign codes Z79.84, Long-term (current) use of oral hypoglycemic drugs, and Z79.85, Long-term (current) use of injectable non-insulin antidiabetic drugs. Code Z79.4 should not be assigned if insulin is given temporarily to bring a secondary diabetic patient’s blood sugar under control during an encounter.

Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)

Z74.01 Bed confinement status Z76.82 Awaiting organ transplant status Z78 Other specified health status Code Z78.1, Physical restraint status, may be used when it is documented by the provider that a patient has been put in restraints during the current encounter. Please note that this code should not be reported when it is documented by the provider that a patient is temporarily restrained during a procedure. Z79 Long- term (current) drug therapy Codes from this category indicate a patient’s continuous use of a prescribed drug (including such things as aspirin therapy) for the long-term treatment of a condition or for prophylactic use. It is not for use for patients who have addictions to drugs. This subcategory is not for use of medications for detoxification or maintenance programs to prevent withdrawal symptoms (e.g., methadone maintenance for opiate dependence). Assign the appropriate code for the drug use, abuse, or dependence instead.

Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)

Assign a code from Z79 if the patient is receiving a medication for an extended period as a prophylactic measure (such as for the prevention of deep vein thrombosis) or as treatment of a chronic condition (such as arthritis) or a disease requiring a lengthy course of treatment (such as cancer). Do not assign a code from category Z79 for medication being administered for a brief period of time to

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. Sequencing: 3 Code First instructions — the underlying condition is sequenced before this code when present. See the Code First notes
  2. 7 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  3. 2 Code Also notes — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  4. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  5. 2 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name Z79.818 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes2 notes: Z79.6 — Long term (current) use of immunomodulators and immunosuppressants (via Z79.81.-), Z92.2 — Personal history of drug therapy (via Z79.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code Also instruction: Z51.81 — Encounter for therapeutic drug level monitoring (via Z79.-).

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 1 MS-DRG: DRG 951 (MDC 23).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):FAC025 — Other specified status (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Not acceptable as a principal diagnosis on an inpatient claim.

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified status).

Z79.624 — Long term (current) use of inhibitors of nucleotide synthesis, Z79.630 — Long term (current) use of alkylating agent, Z79.631 — Long term (current) use of antimetabolite agent, Z79.632 — Long term (current) use of antitumor antibiotic, Z79.633 — Long term (current) use of mitotic inhibitor, Z79.634 — Long term (current) use of topoisomerase inhibitor, Z79.64 — Long term (current) use of myelosuppressive agent, Z79.69 — Long term (current) use of other immunomodulators and immunosuppressants, Z79.810 — Long term (current) use of selective estrogen receptor modulators (SERMs), Z79.811 — Long term (current) use of aromatase inhibitors, Z79.82 — Long term (current) use of aspirin, Z79.83 — Long term (current) use of bisphosphonates, Z79.84 — Long term (current) use of oral hypoglycemic drugs, Z79.85 — Long-term (current) use of injectable non-insulin antidiabetic drugs, Z79.890 — Hormone replacement therapy, Z79.891 — Long term (current) use of opiate analgesic, Z79.899 — Other long term (current) drug therapy, Z88.0 — Allergy status to penicillin, Z88.1 — Allergy status to other antibiotic agents, Z88.2 — Allergy status to sulfonamides, +232 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Therapy”; these codes share that main term but sit in a different category of the Tabular List.

F11.20 — Opioid dependence, uncomplicated

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Prostate-Specific Antigen (PSA)

Contextual Map

Every relationship of Z79.818 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run Z79.818 with these 3 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes

Referenced by Code Also instructions

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services[MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,258 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries (14)

  • Long-term (current) (prophylactic) drug therapy (use of), agents affecting estrogen receptors and estrogen levels NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Long-term (current) (prophylactic) drug therapy (use of), estrogen receptor downregulators[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Long-term (current) (prophylactic) drug therapy (use of), fulvestrant (Faslodex)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Long-term (current) (prophylactic) drug therapy (use of), gonadotropin-releasing hormoneagonist (GnRH)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Long-term (current) (prophylactic) drug therapy (use of), goserelin acetate (Zoladex)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Long-term (current) (prophylactic) drug therapy (use of), leuprolide acetate (leuprorelin) (Lupron)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Long-term (current) (prophylactic) drug therapy (use of), megestrol acetate (Megace)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Therapy, drug, long-term (current) (prophylactic), agents affecting estrogen receptors and estrogen levels NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • and 6 more

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (14)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "Z79.818 — Long term (current) use of other agents affecting estrogen receptors and estrogen levels." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/z79.818-long-term-current-use-of-other-agents-affecting-estrogen-receptors-and-estrogen-levels

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Long term (current) use of other agents affecting estrogen receptors and estrogen levels

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Z79.818 in its code family, with their registry titles.

View all codes in the Z79 family