Z86.000 — Personal history of in-situ neoplasm of breast
Z86.000 is a billable, specific ICD-10-CM code for personal history of in-situ neoplasm of breast. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Conditions classifiable to D05
Risk adjustment
Z86.000 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
Z86.000 is named in 8 Medicare coverage policies — 8 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52399Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®, Wyost®, Ospomyv™,Xbryk™,Bomyntra®, Conexxence®, Stoboclo®, Osenvelt®,Bildyos®, Bilprevda®)
- A52849Billing and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography
- A56199Billing and Coding: Molecular Pathology Procedures
- A58652Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
How Z86.000 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Z86.000.
- History›personal›in situ neoplasm›breast
- History›personal›neoplasm›in situ›breast
Related codes at this level
Codes that share Z86.00. If Z86.000 is not quite right, the correct code is usually one of these.
- Z86.001Personal history of in-situ neoplasm of cervix uteri
- Z86.002Personal history of in-situ neoplasm of other and unspecified genital organs
- Z86.003Personal history of in-situ neoplasm of oral cavity, esophagus and stomach
- Z86.004Personal history of in-situ neoplasm of other and unspecified digestive organs
- Z86.005Personal history of in-situ neoplasm of middle ear and respiratory system
- Z86.006Personal history of melanoma in-situ
- Z86.007Personal history of in-situ neoplasm of skin
- Z86.008Personal history of in-situ neoplasm of other site
- Z86.00APersonal history of in-situ neoplasm of the fallopian tube(s)
Questions about Z86.000
- Is Z86.000 a billable ICD-10-CM code?
- Yes. Z86.000 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Z86.000 sit in the tabular list?
- Factors influencing health status and contact with health services (Z00-Z99), in the block Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).