Past history of immunosuppressive drugs or corticosteroids

From CCMDB Wiki
ICD10 Diagnosis
Dx: Past history of immunosuppressive drugs or corticosteroids
ICD10 code: Z92.25
Pre-ICD10 counterpart: none assigned
Charlson/ALERT Scale: none
APACHE Como Component: Immunocompromised
APACHE Acute Component: none
Start Date:
Stop Date:
External ICD10 Documentation

This diagnosis is a part of ICD10 collection.

  • SMW
    • 2019-01-01
    • 2999-12-31
    • Z92.25
  • Cargo

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Additional Info

  • Code this if the patient meets the criteria for any of the drugs listed herein:
List of immunosuppressive drugs   
  • Used to treat an increasing variety of conditions: immune-mediated (RA, UC, Crohn's, lupus, MS, psoriasis, etc); after organ transplant.
  • Only considered immunosuppressive if given systemically (po, im or iv)
  • Corticosteroids (unlike all the others, these only count if > a given daily dose and used for at least 2 weeks prior to admission)
    • Dexamethasone: >0.25 mg/day
    • Hydrocortisone: >40 mg/day
    • Prednisone (methyl-prednisolone): >10 mg/day
    • Prednisolone: >8 mg/day
  • Cancer chemotherapy -- includes any agents, if received within the past 6 months
  • Nonsteroidal immunosuppressives -- includes any of these, if received within the past 1 month
    • Abatacept (Orencia)
    • Azathioprine (Imuran)
    • Adalimumab (Humira)
    • Anakinra (Kineret)
    • Basiliximab (Simulect)
    • Certolizumab (Cimzia)
    • Cyclophosphamide (Cytoxan)
    • Cyclosporine
    • Daclizumab (Zinbryta)
    • Etanercept (Enbrel)
    • Everolimus (Afinitor, Zortress)
    • Golimumag (Simponi)
    • Infliximab (Remicade)
    • Ixekizumab (Taltz)
    • Leflunomide (Arava)
    • Lenalidomide
    • Methotrexate
    • Mycophenolate (CellCept)
    • Natalizumab (Tysabri)
    • Rituximab (Rituxan)
    • Secukinumab (Cosentyx)
    • Sirolimus (Rapasumne)
    • Tacrolimus (Prograf)
    • Tocilizumab (Actemra)
    • Tofacitinib (Xeljanz)
    • Ustekinumab (Stelara)
    • Vedolizumab (Entyvio)

Do not include

  • hydroxychloroquine - as per task meeting 2022-04-20 it is an immune modulator, but not very immunosuppressive
  • As of early 2022, this ICD10 code is also used to identify drug-induced immunosuppression as an APACHE II comorbidity

Guideline for past vs current

Use this code if the intervention happened at any time prior to now, irrespective of ongoing plans for the future. That is, if pt is in between two chemo sessions while in hospital, still code this.

If actually done during this admission, also code the relevant CCI procedure (see #Related CCI Codes).

Past medical history codes

Past medical history codes should only be captured as Comorbid Diagnoses that represent previous procedures or medical situations. Their names usually follow the pattern "Past history of X" or "X, has one". See Category:Past medical history for a list.

Alternate ICD10s to consider coding instead or in addition

Past medical history codes:

Candidate Combined ICD10 codes

Related CCI Codes

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