Z85

Z85: Personal history of malignant neoplasm

Non-billable headerICD-10-CM

Z85 is a non-billable header ICD-10-CM code for personal history of malignant neoplasm. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes2: not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

personal history of benign neoplasm (Z86.01-)
personal history of carcinoma-in-situ (Z86.00-)

Code first

The underlying condition must be sequenced before this code.

any follow-up examination after treatment of malignant neoplasm (Z08)

Use additional code

Add a secondary code to capture the detail described below.

code to identify:
alcohol use and dependence (F10.-)
exposure to environmental tobacco smoke (Z77.22)
history of tobacco dependence (Z87.891)
occupational exposure to environmental tobacco smoke (Z57.31)
tobacco dependence (F17.-)
tobacco use (Z72.0)

Other codes that can never be billed with Z85

Their own Excludes1 notes name this code, so the conflict is not listed above.

C88Malignant immunoproliferative diseases and certain other B-cell lymphomas
C90Multiple myeloma and malignant plasma cell neoplasms
C91Lymphoid leukemia
C92Myeloid leukemia
C93Monocytic leukemia
C94Other leukemias of specified cell type
C95Leukemia of unspecified cell type
C96Other and unspecified malignant neoplasms of lymphoid, hematopoietic and related tissue

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead Z85

10 child codes. Green means billable.