Z79.818: Long term (current) use of other agents affecting estrogen receptors and estrogen levels
Z79.818, long term (current) use of other agents affecting estrogen receptors and estrogen levels, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 11 HCPCS Level II codes, including G0130 (Single energy x-ray absorptiometry (sexa) bone density…), J0897 (Injection, denosumab, 1 mg), Q5136 (Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg). The articles come from 3 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 Z79.818 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0130 | Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) | Special coverage instructions apply | — | 2 |
| J0897 | Injection, denosumab, 1 mg | Carrier judgment | — | 1 |
| Q5136 | Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5157 | Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5158 | Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5159 | Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5162 | Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5165 | Injection, denosumab-mobz (oziltus), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5166 | Injection, denosumab-desu (osvyrti/jubereq), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5167 | Injection, denosumab-qbde (enoby/xtrenbo), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5171 | Injection, denosumab-mobz (boncresa), biosimilar, 1 mg | Carrier judgment | — | 1 |
Medicare policy articles listing Z79.818
- A59040: Billing and Coding: Bone Mass Measurement (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36460, L39268
- A57132: Billing and Coding: Bone Mass Measurement (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36460, L39268
- A52399: Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®) and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 10 Level II codes)
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)
- Z79.810 — Long term (current) use of selective estrogen receptor modulators…
- Z79.811 — Long term (current) use of aromatase inhibitors
- Z79.83 — Long term (current) use of bisphosphonates
- Z79.85 — Long-term (current) use of injectable non-insulin antidiabetic drugs
- Z79.891 — Long term (current) use of opiate analgesic
- Z79.899 — Other long term (current) drug therapy
- Z79.01 — Long term (current) use of anticoagulants
- Z79.3 — Long term (current) use of hormonal contraceptives
- Z79.51 — Long term (current) use of inhaled steroids
- Z79.52 — Long term (current) use of systemic steroids
Frequently asked questions
Does Medicare cover Z79.818 (Long term (current) use of other agents affecting estrogen…)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list Z79.818 as a covered diagnosis for 11 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 Z79.818?
The Level II codes from the policies most specific to this diagnosis are G0130 (Single energy x-ray absorptiometry (sexa) bone density…, 2 articles); J0897 (Injection, denosumab, 1 mg, 1 article); Q5136 (Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg, 1 article); Q5157 (Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar…, 1 article); Q5158 (Injection, denosumab-bnht (bomyntra/conexxence)…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list Z79.818?
A59040 (Billing and Coding: Bone Mass Measurement); A57132 (Billing and Coding: Bone Mass Measurement); A52399 (Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®) and biosimilars).
What is ICD-10-CM code Z79.818?
Z79.818 is the ICD-10-CM code for long term (current) use of other agents affecting estrogen receptors and estrogen levels, in category Z79 (Long term (current) drug therapy), chapter 22: Factors influencing health status and contact with health services.
Next steps
- Run a reimbursement report for a device billed under G0130
- Watch G0130 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0130
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