Z79.85 ICD-10-CM Code: Long-term (current) use of injectable non-insulin antidiabetic drugs
Z79.85 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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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)
Z79.85
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceLong-term (current) use of injectable non-insulin antidiabetic drugs
Patient is currently taking injectable non-insulin diabetes medications, such as GLP-1 agonists or SGLT2 inhibitors given by injection.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for Z79.85. Check the code and parent instructions in the Code Book.
Excludes 2
Official- long term (current) use of insulin (Z79.4)
- long term (current) use of oral hypoglycemic drugs (Z79.84)
- drug abuse and dependence (F11-F19)Inherited from Z79
- drug use complicating pregnancy, childbirth, and the puerperium (O99.32-)Inherited from Z79
Related Codes
Includes
Official- long term (current) drug use for prophylactic purposesInherited from Z79
Excludes 1
OfficialNo Excludes 1 notes are included in this display for Z79.85. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for Z79.85. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for Z79.85. 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
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 Z79.85 an HCC code?
No. Z79.85 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
- Z79.85
- Description
- Long-term (current) use of injectable non-insulin antidiabetic drugs
- 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
Z79.85 is the ICD-10-CM diagnosis code for long-term (current) use of injectable non-insulin antidiabetic drugs. Patient is currently taking injectable non-insulin diabetes medications, such as GLP-1 agonists or SGLT2 inhibitors given by injection. Z79.85 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).
Z79.85 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.
Document the specific injectable medication (semaglutide, dulaglutide, liraglutide, etc.).
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for Z79.85 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific injectable medication (semaglutide, dulaglutide, liraglutide, etc.)
- •Distinguish from insulin therapy, which has separate coding