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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)

Z79

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Long term (current) drug therapy

Long term (current) drug therapy

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
Z7Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
Z79Long term (current) drug therapy

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for Z79 in this effective period.

Excludes 2

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

Related Child Codes

Official
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
Z79.4Long term (current) use of insulin

Includes

Official
  • long term (current) drug use for prophylactic purposes

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for Z79 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for Z79 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for Z79 in this effective period.

Code Also

Official
  • any therapeutic drug level monitoring (Z51.81)

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

Z79 is the ICD-10-CM diagnosis code for long term (current) drug therapy. Z79 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons with potential health hazards related to family and personal history and certain conditions influencing health status (z77-z99).

Header codes like Z79 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at Z79's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z79 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • long term (current) drug use for prophylactic purposes

Excludes 2 — Not included here, may code separately

  • 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)

Child Codes

Code Hierarchy

Z79Long term (current) drug therapy
Z79Long term (current) drug therapy

More on Z79

Related condition guides

Referenced in blog posts

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