Z79.899 Insurance Policy Changes

ICD-10 Z79.899 is officially defined as "Other long term (current) drug therapy." code Z79.899 is referenced in 8 tracked payer policy changes from Blue Cross & Blue Shield of Mississippi and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code Z79.899 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Blue Cross & Blue Shield of Mississippi · Effective Oct 1, 2026Medium impact
Vitamin D Testing
Serum measurement of vitamin D (25-hydroxyvitamin D [25(OH)D], CPT 82306) is considered medically necessary up to four times per calendar year for the following conditions, among others: biliary cirrhosis, celiac disease, hypercalcemia or hypocalcemia, hyperparathyroidism or hypoparathyroidism, intestinal malabsorption, liver cirrhosis, long-term use of anticonvulsants, glucocorticoids or other medications known to lower vitamin D levels, malnutrition, osteomalacia, osteoporosis, rickets, sarcoidosis, stage III-V chronic kidney disease and end stage renal disease, and vitamin D deficiency on replacement therapy to monitor treatment efficacy. Routine serum vitamin D testing performed for screening purposes in asymptomatic patients is considered not medically necessary. Intestinal failure-associated liver disease (ICD-10 K76.83) is listed as a new diagnosis code effective 10/01/2026.
Blue Cross & Blue Shield of Mississippi · Effective Jan 1, 2026Medium impact
Urine Drug Testing
Blue Cross Blue Shield Association policy 2.04.98 added CPT 0603U, a presumptive drug assay of 77 drugs or metabolites in urine by LC-MS/MS reported as positive or negative, which the code table lists as new as of 01/01/2026 and as investigational. The policy considers routine presumptive urine drug testing not medically necessary in chronic non-cancer pain management and substance use disorder treatment, and considers hair drug testing and oral fluid drug testing investigational in both settings. Presumptive urine drug testing is medically necessary only for the baseline screening and monitoring frequencies the policy lists for each setting.
Aetna · Identified Aug 19, 2026Medium impact
Varicella and Herpes Zoster Vaccines (CPB 0115, reviewed 2026-03-19)
Aetna Clinical Policy Bulletin 0115 covers varicella vaccine as a preventive service under the CDC ACIP recommendations, and covers the combined MMRV vaccine (ProQuad) as an alternative to separate MMR and varicella vaccines for children 12 months to 12 years where simultaneous administration of MMR and varicella vaccines is indicated. It covers the two-dose recombinant zoster vaccine Shingrix for prevention of herpes zoster in adults aged 50 years and older, in adults aged 50 years and older who previously received Zostavax, and in adults aged 18 years and older who are or will be at increased risk of herpes zoster due to immunodeficiency or immunosuppression. Shingrix is considered experimental, investigational or unproven for treatment of zoster or postherpetic neuralgia, for prevention of primary varicella infection, for repeat booster doses beyond the two-dose series and for all other indications not listed, and Zostavax is no longer available for use in the United States as of November 18, 2020.
Aetna · Identified Aug 17, 2026Medium impact
Grenz Ray Therapy for Skin Disorders (CPB 0231, reviewed 2026-04-13)
Aetna considers Grenz ray therapy experimental, investigational, or unproven for treating dermatologic conditions, because the published peer-reviewed literature has inadequate evidence of its effectiveness for skin disorders. Grenz rays are x-rays and should be treated with the same caution as other ionizing radiation. CPT 96900 (actinotherapy) is listed as not covered for the listed indications, and unlisted code 77499 is required for Grenz ray therapy. Last reviewed 04/13/2026, with the next review set for 02/25/2027.
Aetna · Identified Aug 15, 2026Medium impact
Quantitative Sensory Testing Methods (CPB 0357, reviewed 2026-05-22)
Quantitative sensory testing (QST), current perception threshold (CPT) testing, voltage-actuated sensory nerve conduction threshold (VsNCT) testing, and quantitative thermal testing for early diagnosis of leprosy are considered experimental, investigational, or unproven for the uses listed in this policy, because their effectiveness or clinical value has not been established. Listed uses include evaluating fibromyalgia pain, chronic itch, chronic pelvic pain, and shoulder pain, and diagnosing restless legs syndrome and small fiber neuropathy in postural orthostatic tachycardia syndrome. CPT codes 0106T through 0110T and HCPCS code G0255 are not covered for the listed indications.
Aetna · Identified Aug 14, 2026Medium impact
Electroretinography (CPB 0854, reviewed 2025-12-24)
The electroretinography (ERG) policy was last reviewed December 24, 2025. ERG is medically necessary for the work-up of congenital nystagmus and as an adjunctive modality for establishing loss of retinal function and distinguishing retinal from optic nerve lesions, full-field ERG is medically necessary for congenital stationary night blindness and for evaluating Vogt-Koyanagi-Harada disease and exudative retinal detachment, and multi-focal ERG is medically necessary for detecting chloroquine and hydroxychloroquine toxicity. ffERG or mfERG is medically necessary for evaluating Stargardt disease in children, while full-field flash ERG monitoring during endoscopic trans-sphenoidal pituitary mass resection, global flash ERG for refractive errors, and pattern ERG for antidepressant selection, amblyopia, depression, glaucoma, macular drusen and all other indications are experimental, investigational or unproven.
Aetna · Identified Aug 12, 2026Medium impact
Vitamin D Assay (CPB 0945, reviewed 2025-12-23)
Aetna considers measurements of serum 25-hydroxyvitamin D experimental, investigational, or unproven for routine preventive screening. CPT codes 0038U, 82306 and 82652 are covered if selection criteria are met, and ICD-10 codes covered if selection criteria are met include vitamin D deficiency (E55.0 to E55.9), chronic kidney disease (N18.1 to N18.9) and osteoporosis (M80.00xA to M81.8). ICD-10 codes not covered for the indications listed in the policy include malignant neoplasms of the breast (C50.011 to C50.929) and prostate (C61), diabetes mellitus (E08.00 to E13.9), Alzheimer's disease (G30.0 to G30.9) and screening encounters for malignant neoplasms (Z12.0 to Z12.9).
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Free Testosterone Testing
Serum free testosterone (CPT 84402) is medically necessary to distinguish a sex hormone-binding globulin (SHBG) abnormality from hypogonadism in obese males with symptoms of hypogonadism when total testosterone is low, to diagnose hyperandrogenism in symptomatic females, and in patients with a medical diagnosis that may increase or decrease SHBG levels. It is not medically necessary to diagnose testosterone deficiency in non-obese males with symptoms of hypogonadism, or when performed for screening of asymptomatic patients. Free testosterone should be performed by equilibrium dialysis, and free testosterone measured by an analog method should never be ordered.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code Z79.899?

There are 8 tracked policy changes affecting code Z79.899, including updates from Blue Cross & Blue Shield of Mississippi, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code Z79.899?

Payers that have issued tracked updates for code Z79.899 include: Blue Cross & Blue Shield of Mississippi, Aetna.

How do I get notified when code Z79.899 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code Z79.899. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for code Z79.899?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

All billing codes J3590 C9399 J3490 99215 99213 99202

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Vitamin D Testing

Urine Drug Testing

Varicella and Herpes Zoster Vaccines (CPB 0115, reviewed 2026-03-19)

Grenz Ray Therapy for Skin Disorders (CPB 0231, reviewed 2026-04-13)

Quantitative Sensory Testing Methods (CPB 0357, reviewed 2026-05-22)

Electroretinography (CPB 0854, reviewed 2025-12-24)

Vitamin D Assay (CPB 0945, reviewed 2025-12-23)

Free Testosterone Testing

What insurance policy changes affect code Z79.899?

Which payers have updated policy for code Z79.899?

How do I get notified when code Z79.899 policy changes?

Why do payers change policies for code Z79.899?