Z79.810: Long term (current) use of selective estrogen receptor modulators (SERMs)

Z79.810, long term (current) use of selective estrogen receptor modulators (SERMs), is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 21 HCPCS Level II codes, including J3489 (Injection, zoledronic acid, 1 mg), J1740 (Injection, ibandronate sodium, 1 mg), J2430 (Injection, pamidronate disodium, per 30 mg). The articles come from 2 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with Z79.810 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J3489Injection, zoledronic acid, 1 mgCarrier judgment—1
J1740Injection, ibandronate sodium, 1 mgCarrier judgment—1
J2430Injection, pamidronate disodium, per 30 mgSpecial coverage instructions apply—1
J0897Injection, denosumab, 1 mgCarrier judgment—1
Q5136Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mgCarrier judgment—1
Q5157Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mgCarrier judgment—1
Q5158Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mgCarrier judgment—1
Q5159Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mgCarrier judgment—1
Q5162Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mgCarrier judgment—1
Q5165Injection, denosumab-mobz (oziltus), biosimilar, 1 mgCarrier judgment—1
Q5166Injection, denosumab-desu (osvyrti/jubereq), biosimilar, 1 mgCarrier judgment—1
Q5167Injection, denosumab-qbde (enoby/xtrenbo), biosimilar, 1 mgCarrier judgment—1
Q5171Injection, denosumab-mobz (boncresa), biosimilar, 1 mgCarrier judgment—1
Q5129Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mgCarrier judgment—1
Q5126Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mgCarrier judgment—1
Q5118Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mgCarrier judgment—1
Q5107Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mgSpecial coverage instructions apply—1
J9035Injection, bevacizumab, 10 mgCarrier judgment—1
J3590Unclassified biologicsCarrier judgment—1
C9257Injection, bevacizumab, 0.25 mgSpecial coverage instructions apply—1
Q5160Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mgCarrier judgment—1

Medicare policy articles listing Z79.810

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other Z79 diagnoses (Long term (current) drug therapy)

Frequently asked questions

Does Medicare cover Z79.810 (Long term (current) use of selective estrogen receptor…)?

Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list Z79.810 as a covered diagnosis for 21 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 Z79.810?

The Level II codes from the policies most specific to this diagnosis are J3489 (Injection, zoledronic acid, 1 mg, 1 article); J1740 (Injection, ibandronate sodium, 1 mg, 1 article); J2430 (Injection, pamidronate disodium, per 30 mg, 1 article); J0897 (Injection, denosumab, 1 mg, 1 article); Q5136 (Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list Z79.810?

A56907 (Billing and Coding: Bisphosphonate Drug Therapy); A52399 (Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®) and biosimilars); A52370 (Billing and Coding: Bevacizumab and biosimilars).

What is ICD-10-CM code Z79.810?

Z79.810 is the ICD-10-CM code for long term (current) use of selective estrogen receptor modulators (SERMs), in category Z79 (Long term (current) drug therapy), chapter 22: Factors influencing health status and contact with health services.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 22: Factors influencing health status and contact with health services · All diagnoses · HCPCS lookup