Oncology & Hematology Coding Alert
Look to Condition, not Time, for Correct Z79 Code Use
Question: I have always used three months or longer as the cut off to apply the Z79 codes. Is this still the norm? AAPC Forum Participant Answer: While ICD-10-CM guideline I.C.21.c.3 does not specify a time frame for assigning a code from Z79 (Long-term (current) drug therapy), it does tell you to “assign a code from Z79 if the patient is receiving a medication for an extended period as a prophylactic measure (such as for the prevention of deep vein thrombosis) or as treatment of a chronic condition (such as arthritis) or a disease requiring a lengthy course of treatment (such as cancer).” The guideline also goes on to tell you not to assign a code from Z79 “for medication being administered for a brief period of time to treat an acute illness or injury (such as a course of antibiotics to treat acute bronchitis).” So, you should only use a code from Z79 if the patient has a history of taking the drug over an extended period of time for a condition that is not short-term or acute and that will resolve in the foreseeable future (in other words, if the drug use is “long term”). You should also only use a Z79 code if the patient is taking the medication at the time of the encounter (in other words, if the drug use is “current”).
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