Z92.26 — Personal history of immune checkpoint inhibitor therapy
Is Z92.26 billable?
Yes — Z92.26 is billable for FY2027. Z92.26 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z92.26 may be submitted for encounters from October 1, 2026 through September 30, 2027.
Z92.26 at a glance
| Code | Z92.26 |
|---|---|
| Description | Personal history of immune checkpoint inhibitor therapy |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to Z92.26?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z92.26 directly.
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 Z92.26 group to?
Z92.26 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 Z92.26 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to Z92.26. They show the wording a clinician may have documented, which often differs from the Tabular description.
- History › personal › ICIdrug therapy
- History › personal › immune checkpoint inhibitortherapy
- History › personal › drug therapy › ICIdrug therapy
Inclusion terms
Alternative wording in documentation that is classified to Z92.26.
- Personal history of ICI drug therapy
Excludes2 — not included here — inherited from Z92
The conditions below are not part of Z92.26, but a patient may have both at the same time. When documentation supports it, Z92.26 and the excluded code may both be reported.
- postprocedural states (Z98.-)
Excludes2 — not included here — inherited from Z92.2
The conditions below are not part of Z92.26, but a patient may have both at the same time. When documentation supports it, Z92.26 and the excluded code may both be reported.
- long term (current) drug therapy (Z79.-)
Code also — inherited from Z77-Z99
Two codes may be needed to describe the condition fully. Whether Z92.26 is sequenced first depends on the reason for the encounter.
- any follow-up examination (Z08-Z09)
How long has Z92.26 existed?
Z92.26 first appears in FY2025.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.