Z86.000

Z86.000: Personal history of in-situ neoplasm of breast

Billable / specific codeICD-10-CMPOA exempt

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.

Check Z86.000 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Conditions classifiable to D05

Excludes2 inherited from the categories above Z86.000

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

Written on Z86.0: Personal history of in-situ and benign neoplasms and neoplasms of uncertain behavior

personal history of malignant neoplasms (Z85.-)

Risk adjustment

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

Medicare coverage

Z86.000 is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52399Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®) and biosimilars
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

Alphabetic index entries that lead here

History›personal›in situ neoplasm›breast
History›personal›neoplasm›in situ›breast

The condition this code belongs to

COVID-19 ICD-10 codes

Code history

Unchanged in every release from FY2024 to FY2027.