# Z79.899



## narsenault (Mar 7, 2019)

There is a debate in my department of when you can assign Z79.899 to cover the medical necessity for outpatient services. Some of my peers believe you can only assign Z79.899 per a short list in the appendix in the back of the Optum ICD-10-CM Expert codebook. I believe, per coding guidelines, coding clinic, and the description of the code (other long term (current) drug therapy), it can be assigned. Provided there is supported documentation of a medication not applying to a more specified Z79.xxx code. (ex: Z79.01 for someone prescribed Coumadin.)

Please provide me with anything in regard to Z79.899.


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## pscanlan (Mar 12, 2019)

When I coded pain management, this code was often a supporting diagnosis. I usually used whatever pain code was most accurate (m54.5, M79.7 etc, etc), followed by Z79.899 or Z79.891 depending on the patient's medication regimen. That said, it was always a supporting diagnosis, never primary. It might be okay for primary for drug testing or something of the sort. 

I do not have the Optum book, so I really can't help you with the shortlist you reference. What procedure are you trying to justify with Z79.899 as the solo or primary Dx?


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## narsenault (Mar 13, 2019)

pscanlan said:


> When I coded pain management, this code was often a supporting diagnosis. I usually used whatever pain code was most accurate (m54.5, M79.7 etc, etc), followed by Z79.899 or Z79.891 depending on the patient's medication regimen. That said, it was always a supporting diagnosis, never primary. It might be okay for primary for drug testing or something of the sort.
> 
> I do not have the Optum book, so I really can't help you with the shortlist you reference. What procedure are you trying to justify with Z79.899 as the solo or primary Dx?




Thank you so much for replying,
This usually is for a secondary diagnosis code for ED and Surgical encounter types. We are also questioning when for ancillary services- labs, like Vitamin D. Our goal is to be compliant when covering for medical necessity per the LCD and NCD policies by our Medicare carrier in our region. We have National Government Services, NGS for our region. 
Please let me know if you have any other questions.


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## kbus28 (Apr 16, 2020)

I am billing for a Pain Management provider and we are having a debate on what the primary DX code would be for a urine drug screen (80307) done in the office at the same time as an f/u office visit.  We have an insurance denying 80307 with primary DX of Z79.891- stating it is invalid DX (secondary DX codes are the conditions the PT is being treated for).  In the past this particular insurance paid the 80307 but that was ONLY with the condition or pain DX codes.  

I am now being asked to submit corrected claims with the condition/pain DX primary and Z79.891 secondary.  The reason the urine test is being done is to verify what drugs the PT is or is no taking, therefore I feel Z code should be the primary DX.  Below is an example portion of the note regarding the drug screen.  



Any help or opinions would be appreciated because I am not sure if I am correct!!  Thanks!!


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## thomas7331 (Apr 16, 2020)

Based on the statement in the record here, '_looking for consistent results...for the prescribed medications_', I would code Z51.81 - _Encounter for therapeutic drug level monitoring - _as the primary code, with the appropriate Z79- codes for the particular prescribed drugs that the patient is taking as secondary codes per the 'code also' note under Z51.81 for the testing.  But codes for the pain conditions would also be appropriate if the record shows that is also being evaluated or managed at the same encounter.


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## mvillareal (Aug 18, 2022)

If we have a patient that is on a non insulin injectable medication do will use Z79.899 (other long term drug therapy dx)


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## lgardner (Aug 18, 2022)

mvillareal said:


> If we have a patient that is on a non insulin injectable medication do will use Z79.899 (other long term drug therapy dx)


yes, per ICD-10 guidelines:

Additional code(s) should be assigned from category Z79 to identify the long-term (current) use of insulin, oral hypoglycemic drugs, or injectable non-insulin antidiabetic, as follows:
If the patient is treated with both oral medications and insulin, both code Z79.4, Long term (current) use of insulin, and code Z79.84, Long term (current) use of oral hypoglycemic drugs, should be assigned.
If the patient is treated with both insulin and an injectable non-insulin antidiabetic drug, assign codes Z79.4, Long term (current) use of insulin, and Z79.899, Other long term (current) drug therapy.
If the patient is treated with both oral hypoglycemic drugs and an injectable non-insulin antidiabetic drug, assign codes Z79.84, Long term (current) use of oral hypoglycemic drugs, and Z79.899, Other long term (current) drug therapy.


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