ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 Z79.4

Billable / Specific HCC v28: 19

Long term (current) use of insulin

Z79
Block
0
Synonyms
41
LCDs
11
Payer Policies
6
Linked CPTs

About ICD-10-CM Z79.4

ICD-10-CM code Z79.4 represents Long term (current) use of insulin. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z79). The 2026 edition of ICD-10-CM Z79.4 became effective on October 1, 2025.

Coding Tips for Z79.4

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

Z79.4 is a CMS-HCC v28 risk-adjustment code (category 19). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Type 2 Excludes

Not included here, the excluded code is not part of Z79.4, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • long-term (current) use of injectable non-insulin antidiabetic drugs (Z79.85)
  • long term (current) use of oral antidiabetic drugs (Z79.84)
  • long term (current) use of oral hypoglycemic drugs (Z79.84)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 19
ESRD-HCC
Category 19
RxHCC (Part D)
Category 19

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for Z79.4

Local Coverage Determinations (LCDs) from CMS MACs that list Z79.4 as a covered diagnosis.

41 LCDs

Showing top 10 of 41 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Vitamin D Assay Testing
Article ID: 57736, Effective: 2024-10-01 00:00:00, 553 covered, 0 non-covered
CPT 82652 →
CMS LCD: Billing and Coding: Vitamin D Assay Testing
Article ID: 57736, Effective: 2024-10-01 00:00:00, 553 covered, 0 non-covered
CPT 82306 →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 81479 →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 81517 →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 0344U →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 0003M →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 0468U →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 81599 →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 0166U →
CMS LCD: Billing and Coding: Visual Fields Testing
Article ID: 56551, Effective: 2025-10-01 00:00:00, 1427 covered, 0 non-covered
CPT 92082 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Z79.4.

11 policies

5 Medicare

Billing and Coding: Visual Fields Testing
Policy ID: ART-56551
Billing and Coding: Home Health Plans of Care: Monitoring Glucose Control in the Medicare Home Health Population with Type II Diabetes Mellitus
Policy ID: ART-56674
Billing and Coding: Visual Fields Testing
Policy ID: ART-56799
Billing and Coding: Serum Magnesium
Policy ID: ART-57189
Billing and Coding: Vitamin D Assay Testing
Policy ID: ART-57718

1 Aetna

Pancreas Transplantation Alone (PTA) and Islet Cell Transplantation
Policy ID: CPB-0601

CPT Codes Commonly Billed with Z79.4

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

6 linkages
  • 99211 Established patient minimal visit — BP check, medication refill, nurse visit, immunization admin, post-op follow-up, injury follow-up Primary Care
  • 0003M CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis CMS LCD
  • 0468U CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis CMS LCD
  • 0166U CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis CMS LCD
  • 81517 CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis CMS LCD
  • 0344U CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis CMS LCD

Convert Z79.4 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
Z79.4 V5867 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To Z79.4

Other codes in section Z77-Z99 (Persons with potential health hazards related to family and personal history and certain conditions influencing health status).

Z77 Other contact with and (suspected) exposures hazardous to health (non-billable) Z77.0 Contact with and (suspected) exposure to hazardous, chiefly nonmedicinal, chemicals (non-billable) Z77.01 Contact with and (suspected) exposure to hazardous metals (non-billable) Z77.010 Contact with and (suspected) exposure to arsenic Z77.011 Contact with and (suspected) exposure to lead Z77.012 Contact with and (suspected) exposure to uranium Z77.018 Contact with and (suspected) exposure to other hazardous metals Z77.02 Contact with and (suspected) exposure to hazardous aromatic compounds (non-billable) Z77.020 Contact with and (suspected) exposure to aromatic amines Z77.021 Contact with and (suspected) exposure to benzene Z77.028 Contact with and (suspected) exposure to other hazardous aromatic compounds Z77.09 Contact with and (suspected) exposure to other hazardous, chiefly nonmedicinal, chemicals (non-billable) Z77.090 Contact with and (suspected) exposure to asbestos Z77.098 Contact with and (suspected) exposure to other hazardous, chiefly nonmedicinal, chemicals Z77.1 Contact with and (suspected) exposure to environmental pollution and hazards in the physical environment (non-billable) Z77.11 Contact with and (suspected) exposure to environmental pollution (non-billable) Z77.110 Contact with and (suspected) exposure to air pollution Z77.111 Contact with and (suspected) exposure to water pollution Z77.112 Contact with and (suspected) exposure to soil pollution Z77.118 Contact with and (suspected) exposure to other environmental pollution

ICD-10 Z79.4, Billing FAQ

Is ICD-10 code Z79.4 billable? +

Yes, Z79.4 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 2 Excludes for Z79.4? +

Type 2 Excludes (may be coded together when both conditions exist): long-term (current) use of injectable non-insulin antidiabetic drugs (Z79.85); long term (current) use of oral antidiabetic drugs (Z79.84); long term (current) use of oral hypoglycemic drugs (Z79.84)

Does Z79.4 affect Medicare Advantage HCC risk adjustment? +

Yes. Z79.4 maps to CMS-HCC v28 category 19. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with Z79.4? +

Procedures frequently paired with Z79.4 include: 99211, 0003M, 0468U, 0166U, 81517.

What ICD-9 codes does Z79.4 map to? +

Per CMS GEMs, Z79.4 maps to ICD-9 codes: V5867. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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