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Z79.69 ICD-10-CM Code: Long term (current) use of other immunomodulators and immunosuppressants

Z79.69 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupZ79.69

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)

Z79.69

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Long term (current) use of other immunomodulators and immunosuppressants

A patient is currently taking other immunomodulating or immunosuppressing medications not specifically classified elsewhere.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Inclusion Terms

Official

No inclusion terms are included in this display for Z79.69. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • drug abuse and dependence (F11-F19)Inherited from Z79, Z79.6
  • drug use complicating pregnancy, childbirth, and the puerperium (O99.32-)Inherited from Z79, Z79.6
  • long term (current) use of steroids (Z79.5-)Inherited from Z79, Z79.6
  • long term (current) use of agents affecting estrogen receptors and estrogen levels (Z79.81-)Inherited from Z79, Z79.6

Includes

Official
  • long term (current) drug use for prophylactic purposesInherited from Z79

Excludes 1

Official

No Excludes 1 notes are included in this display for Z79.69. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for Z79.69. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for Z79.69. Check the code and parent instructions in the Code Book.

Code Also

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

Buddy Documentation Tip

HCC Buddy guidance
Use for medications like interferon, imiquimod, thalidomide, or other immune-modulating agents not covered by more specific codes
Document the specific medication name in the medical record for clarity

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is Z79.69 an HCC code?

No. Z79.69 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code
Z79.69
Description
Long term (current) use of other immunomodulators and immunosuppressants
HCC (V28)
No CMS-HCC V28 mapping
RAF reference coefficient
Billable
Yes
Payment year
2026

Coder workflow notes

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What This Code Means

Z79.69 is the ICD-10-CM diagnosis code for long term (current) use of other immunomodulators and immunosuppressants. A patient is currently taking other immunomodulating or immunosuppressing medications not specifically classified elsewhere. Z79.69 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).

Z79.69 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Use for medications like interferon, imiquimod, thalidomide, or other immune-modulating agents not covered by more specific codes.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for Z79.69 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use for medications like interferon, imiquimod, thalidomide, or other immune-modulating agents not covered by more specific codes
  • Document the specific medication name in the medical record for clarity

Child Codes

Code Hierarchy

Z79.69 code history

Code setChange
FY2023 (effective Oct 1, 2022)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Also searched as

  • Z79 69
  • Z7969

More on Z79.69

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