Z85.46

Z85.46: Personal history of malignant neoplasm of prostate

Billable / specific codeICD-10-CMPOA exempt

Z85.46 is a billable, specific ICD-10-CM code for personal history of malignant neoplasm of prostate. It is valid for submission on a claim.

Check Z85.46 with the rest of the claim: free scrubber

Excludes2 inherited from the categories above Z85.46

Not part of this code, but both may be coded when both are present.

Written on Z85: Personal history of malignant neoplasm

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

Other codes that can never be billed with Z85.46

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

Z87.430Personal history of prostatic dysplasia

Risk adjustment

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

Medicare coverage

Z85.46 is named in 30 Medicare coverage policies: 30 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52370Billing and Coding: Bevacizumab and biosimilars
A52399Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®) and biosimilars
A52453Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs
A52479Oral Anticancer Drugs - Policy Article

Z85.46: Personal history of malignant neoplasm of prostate

Excludes2 inherited from the categories above Z85.46

Other codes that can never be billed with Z85.46

Risk adjustment

Medicare coverage

Alphabetic index entries that lead here

Code history

Other codes under Z85.4