Z86.004 — Personal history of in-situ neoplasm of other and unspecified digestive organs
Z86.004 is a billable, specific ICD-10-CM code for personal history of in-situ neoplasm of other and unspecified digestive organs. 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 D01
- Personal history of anal intraepithelial neoplasia (AIN III)
Risk adjustment
Z86.004 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
Z86.004 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.
- A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
- A56612Billing and Coding: CT of the Head
- A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A57342Billing and Coding: Diagnostic and Therapeutic Colonoscopy
How Z86.004 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 Z86.004.
- History›personal›in situ neoplasm›digestive organs, specified NEC
- History›personal›neoplasia›anal intraepithelial, III [AIN III]
- History›personal›neoplasm›in situ›digestive organs, specified NEC
Related codes at this level
Codes that share Z86.00. If Z86.004 is not quite right, the correct code is usually one of these.
- Z86.000Personal history of in-situ neoplasm of breast
- 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
- Z86.005Personal 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 Z86.004
- Is Z86.004 a billable ICD-10-CM code?
- Yes. Z86.004 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Z86.004 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).