ICD-10 Coding for Estrogen Therapy(Z79.810, Z79.890)
Complete ICD-10-CM coding and documentation guide for Estrogen Therapy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Estrogen Therapy
Z79.810-Z79.899Primary Range
Long-term (current) drug therapy
This range includes codes for long-term use of specific drug therapies, including SERMs, aromatase inhibitors, and hormone replacement therapy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z79.810 | Long term (current) use of selective estrogen receptor modulators (SERMs) | Use for patients on SERMs for breast cancer prevention or osteoporosis. |
|
| Z79.890 | Hormone replacement therapy | Use for systemic hormone replacement therapy in postmenopausal women. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for estrogen therapy
Essential facts and insights about Estrogen Therapy
Primary ICD-10-CM Codes for estrogen therapy
Decision Criteria
clinical Criteria
- Patient is on SERM for breast cancer prevention.
Applicable To
- Tamoxifen
- Raloxifene
Excludes
- Hormone replacement therapy (Z79.890)
Clinical Validation Requirements
- Bone density scores
- Breast cancer risk factors
Code-Specific Risks
- Incorrectly coding as hormone replacement therapy
Coding Notes
- Ensure documentation specifies the SERM and its indication.
Z79.890 - Hormone replacement therapy
Use for systemic hormone replacement therapy in postmenopausal women.
Applicable To
- Systemic hormone replacement therapy
Excludes
- Vaginal estrogen (Z79.899)
Clinical Validation Requirements
- Menopausal status
- Serum estradiol levels
Coding Notes
Document the formulation and dose of hormone therapy.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Estrogen Therapy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z79.810.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Use specific terms and include all relevant details.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Ensure documentation specifies whether the therapy is a SERM or systemic hormone replacement.
Impact
Using Z79.810 without a breast cancer code when it's for prevention.
Mitigation Strategy
Ensure supporting documentation of risk factors.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Estrogen Therapy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Estrogen Therapy
Use these documentation templates to ensure complete and accurate documentation for Estrogen Therapy. These templates include all required elements for proper coding and billing.
Postmenopausal woman on hormone replacement therapy
Specialty: EndocrinologyRequired Elements
- Medication name
- Dose
- Frequency
- Indication
- Monitoring
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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