ICD-10-CM Code for Current PPI Use
The ICD-10-CM code for current use of a proton pump inhibitor is Z79.899 (Other long-term [current] drug therapy).
Primary Code Selection
- Z79.899 is the appropriate code for documenting current PPI use when the medication is being taken for ongoing therapeutic purposes 1
- This code falls under the category of "Persons with potential health hazards related to family and personal history and certain conditions influencing health status" 1
Clinical Context for Code Assignment
- The code should be assigned when PPIs are being used for documented indications such as:
Important Documentation Considerations
- Always document the underlying indication for PPI therapy alongside the Z79.899 code, as appropriate use requires a valid clinical indication 1, 6
- The primary diagnosis code (such as K21.9 for GERD or history of GI bleeding) should be listed first, with Z79.899 as a secondary code 1
- For patients on dual antiplatelet therapy (DAPT) or anticoagulants, the European Society of Cardiology recommends documenting the specific bleeding risk factors that justify PPI use 3
Common Pitfalls to Avoid
- Do not use Z79.899 for short-term PPI therapy (less than several weeks) - this code is specifically for long-term or current ongoing use 1
- Studies show that 52-65% of PPI prescriptions in skilled nursing facilities lack appropriate diagnostic codes, leading to regulatory concerns and unnecessary medication costs 1
- Ensure the medical record clearly documents why the PPI is indicated, as regulations require that drug regimens be free from unnecessary medications 1, 6
- Regular review of PPI continuation is essential - approximately 25% of users continue PPIs for more than 1 year, and 28% for more than 3 years, often without ongoing indication 6