ICDcodes.org
FY2027

Z79.620Long term (current) use of immunosuppressive biologic

Billable

Is Z79.620 billable?

Yes — Z79.620 is billable for FY2027. Z79.620 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z79.620 may be submitted for encounters from October 1, 2026 through September 30, 2027.

Z79.620 at a glance

CodeZ79.620
DescriptionLong term (current) use of immunosuppressive biologic
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

What Medicare edits apply to Z79.620?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z79.620 directly.

Cannot be a principal diagnosis — MCE edit 9

CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.

Which MS-DRGs does Z79.620 group to?

Z79.620 sits in MDC 23 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 949Aftercare with CC/MCCmedical
  • 950Aftercare without CC/MCCmedical

How is Z79.620 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to Z79.620. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Long-termadalimumab (current) (prophylactic) drug therapy (use of)
  • Long-termetanercept (current) (prophylactic) drug therapy (use of)
  • Long-termimmunosuppressive biologic (current) (prophylactic) drug therapy (use of)
  • Long-terminfliximab (current) (prophylactic) drug therapy (use of)
  • Long-termmonoclonal antibodies (current) (prophylactic) drug therapy (use of)

Inclusion terms

Alternative wording in documentation that is classified to Z79.620.

  • Long term (current) use of adalimumab
  • Long term (current) use of etanercept
  • Long term (current) use of infliximab
  • Long term (current) use of monoclonal antibodies

Excludes2 — not included here — inherited from Z79

The conditions below are not part of Z79.620, but a patient may have both at the same time. When documentation supports it, Z79.620 and the excluded code may both be reported.

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

Excludes2 — not included here — inherited from Z79.6

The conditions below are not part of Z79.620, but a patient may have both at the same time. When documentation supports it, Z79.620 and the excluded code may both be reported.

  • long term (current) use of steroids (Z79.5-)
  • long term (current) use of agents affecting estrogen receptors and estrogen levels (Z79.81-)

Code also — inherited from Z77-Z99

Two codes may be needed to describe the condition fully. Whether Z79.620 is sequenced first depends on the reason for the encounter.

  • any follow-up examination (Z08-Z09)

Code also — inherited from Z79

Two codes may be needed to describe the condition fully. Whether Z79.620 is sequenced first depends on the reason for the encounter.

  • any therapeutic drug level monitoring (Z51.81)

How long has Z79.620 existed?

Z79.620 first appears in FY2023.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

What other codes are in the Z79.62 family? (4)