MCMCB Pro
Z79.4

Z79.4Long term (current) use of insulin

Billable / specific codeICD-10-CMPOA exempt

Z79.4 is a billable, specific ICD-10-CM code for long term (current) use of insulin. It is valid for submission on a claim.

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

  • 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)

Risk adjustment

Z79.4 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

  • HCC 38 Diabetes with No, Glycemic, or Unspecified Complications0.166 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

Z79.4 is named in 14 Medicare coverage policies 14 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

  • A56551Billing and Coding: Visual Fields Testing
  • A56674Billing and Coding: Home Health Plans of Care: Monitoring Glucose Control in the Medicare Home Health Population with Type II Diabetes Mellitus
  • A56799Billing and Coding: Visual Fields Testing
  • A57189Billing and Coding: Serum Magnesium

How Z79.4 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Z79.4.

  • Long-terminsulin
  • Therapydrug, long-terminsulin

Related codes at this level

Codes that share Z79. If Z79.4 is not quite right, the correct code is usually one of these.

Questions about Z79.4

Is Z79.4 a billable ICD-10-CM code?
Yes. Z79.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z79.4 sit in the tabular list?
Factors influencing health status and contact with health services (Z00-Z99), in the block Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.