Z79.85: Long-term (current) use of injectable non-insulin antidiabetic drugs
Z79.85, long-term (current) use of injectable non-insulin antidiabetic drugs, is listed as a covered diagnosis in 7 Medicare billing and coding articles that apply to 38 HCPCS Level II codes, including J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 mg), J1245 (Injection, dipyridamole, per 10 mg). The articles come from 4 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 Z79.85 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 4 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 4 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 4 |
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 3 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 3 |
| J3490 | Unclassified drugs | Special coverage instructions apply | — | 2 |
| M1211 | Most recent glycemic status assessment (hba1c or gmi) level > 9.0% | Carrier judgment | — | 1 |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | Special coverage instructions apply | — | 1 |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | Special coverage instructions apply | — | 1 |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | Special coverage instructions apply | — | 1 |
| J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) | Special coverage instructions apply | — | 1 |
| J0888 | Injection, epoetin beta, 1 microgram, (for non esrd use) | Special coverage instructions apply | — | 1 |
| Q5105 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units | Special coverage instructions apply | — | 1 |
| J0887 | Injection, epoetin beta, 1 microgram, (for esrd on dialysis) | Special coverage instructions apply | — | 1 |
| J0890 | Injection, peginesatide, 0.1 mg (for esrd on dialysis) | Carrier judgment | — | 1 |
| Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | Special coverage instructions apply | — | 1 |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | Special coverage instructions apply | — | 2 |
| 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 | — | 1 |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | Carrier judgment | — | 1 |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | Carrier judgment | — | 1 |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | Carrier judgment | — | 1 |
| A9505 | Thallium tl-201 thallous chloride, diagnostic, per millicurie | Carrier judgment | — | 1 |
| A9526 | Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries | Carrier judgment | — | 1 |
| A4641 | Radiopharmaceutical, diagnostic, not otherwise classified | Carrier judgment | — | 1 |
| A9501 | Technetium tc-99m teboroxime, diagnostic, per study dose | Carrier judgment | — | 1 |
13 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing Z79.85
- A56686: Billing and Coding: HbA1c (Palmetto GBA (MAC - Part B); 1 Level II codes). LCD with the same title: L33431
- A56795: Billing and Coding: Erythropoiesis Stimulating Agents (ESAs) (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34633
- 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
- A57183: Billing and Coding: Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L34324
- A56476: Billing and Coding: Cardiac Radionuclide Imaging (Palmetto GBA (MAC - Part A, MAC - Part B); 13 Level II codes). LCD with the same title: L33457
- A57306: Billing and Coding: Transthoracic Echocardiography (TTE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 19 Level II codes). LCD with the same title: L33577, L34338
- A56625: Billing and Coding: Echocardiography (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L37379
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
- Z79.818 — Long term (current) use of other agents affecting estrogen receptors…
- Z79.83 — Long term (current) use of bisphosphonates
- 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 Z79.85 (Long-term (current) use of injectable non-insulin…)?
Medicare covers items and services, not diagnoses. 7 Medicare billing and coding articles list Z79.85 as a covered diagnosis for 38 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 Z79.85?
The Level II codes from the policies most specific to this diagnosis are J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 4 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 4 articles); J1245 (Injection, dipyridamole, per 10 mg, 4 articles); J0461 (Injection, atropine sulfate, 0.01 mg, 3 articles); J0280 (Injection, aminophyllin, up to 250 mg, 3 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list Z79.85?
A56686 (Billing and Coding: HbA1c); A56795 (Billing and Coding: Erythropoiesis Stimulating Agents (ESAs)); A57132 (Billing and Coding: Bone Mass Measurement), and 4 more articles.
What is ICD-10-CM code Z79.85?
Z79.85 is the ICD-10-CM code for long-term (current) use of injectable non-insulin antidiabetic drugs, 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 J0153
- Watch J0153 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0153
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