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Z79.81 ICD-10-CM Code: Long term (current) use of agents affecting estrogen receptors and estrogen levels

ICD-10-CM Code View

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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)

Z79.81

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

Long term (current) use of agents affecting estrogen receptors and estrogen levels

Long term (current) use of agents affecting estrogen receptors and estrogen levels

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
Z79Long term (current) drug therapy
Z79.8Other long term (current) drug therapy
Z79.81Long term (current) use of agents affecting estrogen receptors and estrogen levels

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for Z79.81 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for Z79.81 in this effective period.

Related Child Codes

Official
Z79.810Long term (current) use of selective estrogen receptor modulators (SERMs)
Z79.811Long term (current) use of aromatase inhibitors
Z79.818Long term (current) use of other agents affecting estrogen receptors and estrogen levels

Includes

Official

ICD-10-CM does not list Includes notes for Z79.81 in this effective period.

Excludes 1

Official
  • hormone replacement therapy (Z79.890)

Code First

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

Use Additional

Official
  • 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)

Code Also

Official

ICD-10-CM does not list Code Also instructions for Z79.81 in this effective period.

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.

Coder workflow notes

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What This Code Means

Z79.81 is the ICD-10-CM diagnosis code for long term (current) use of agents affecting estrogen receptors and estrogen levels. Z79.81 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 Z79.81 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 Z79.81'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 Z79.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • hormone replacement therapy (Z79.890)

Use Additional Code

  • 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)

Code First

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

Child Codes

Code Hierarchy

More on Z79.81

Related condition guides

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