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ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 Z78.9

Billable / Specific

Other specified health status

Z78
Block
0
Synonyms
22
LCDs
4
Payer Policies
5
Linked CPTs

About ICD-10-CM Z78.9

ICD-10-CM code Z78.9 represents Other specified health status. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z78). The 2026 edition of ICD-10-CM Z78.9 became effective on October 1, 2025.

Medicare LCD Coverage for Z78.9

Local Coverage Determinations (LCDs) from CMS MACs that list Z78.9 as a covered diagnosis.

22 LCDs

Showing top 10 of 22 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Article ID: 53095, Effective: 2024-10-01 00:00:00, 43 covered, 0 non-covered
CPT 88120 →
CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Article ID: 53095, Effective: 2024-10-01 00:00:00, 43 covered, 0 non-covered
CPT 88121 →
CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Article ID: 53095, Effective: 2024-10-01 00:00:00, 43 covered, 0 non-covered
CPT 86316 →
CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Article ID: 53095, Effective: 2024-10-01 00:00:00, 43 covered, 0 non-covered
CPT 86294 →
CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Article ID: 53095, Effective: 2024-10-01 00:00:00, 43 covered, 0 non-covered
CPT 86386 →
CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Article ID: 55028, Effective: 2025-11-06 00:00:00, 60 covered, 0 non-covered
CPT 88120 →
CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Article ID: 55028, Effective: 2025-11-06 00:00:00, 60 covered, 0 non-covered
CPT 88121 →
CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Article ID: 55028, Effective: 2025-11-06 00:00:00, 60 covered, 0 non-covered
CPT 86316 →
CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Article ID: 55028, Effective: 2025-11-06 00:00:00, 60 covered, 0 non-covered
CPT 86294 →
CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Article ID: 55028, Effective: 2025-11-06 00:00:00, 60 covered, 0 non-covered
CPT 86386 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Z78.9.

4 policies

4 Medicare

Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Policy ID: ART-53095
Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Policy ID: ART-55028
Billing and Coding: Bladder/Urothelial Tumor Markers
Policy ID: ART-56471
Billing and Coding: Intravenous Immune Globulin
Policy ID: ART-56779

CPT Codes Commonly Billed with Z78.9

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

5 linkages
  • 88120 CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers CMS LCD
  • 86386 CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers CMS LCD
  • 86294 CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers CMS LCD
  • 86316 CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers CMS LCD
  • 88121 CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers CMS LCD

Convert Z78.9 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
Z78.9 V4989 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To Z78.9

Other codes in section Z77-Z99 (Persons with potential health hazards related to family and personal history and certain conditions influencing health status).

Z77 Other contact with and (suspected) exposures hazardous to health (non-billable) Z77.0 Contact with and (suspected) exposure to hazardous, chiefly nonmedicinal, chemicals (non-billable) Z77.01 Contact with and (suspected) exposure to hazardous metals (non-billable) Z77.010 Contact with and (suspected) exposure to arsenic Z77.011 Contact with and (suspected) exposure to lead Z77.012 Contact with and (suspected) exposure to uranium Z77.018 Contact with and (suspected) exposure to other hazardous metals Z77.02 Contact with and (suspected) exposure to hazardous aromatic compounds (non-billable) Z77.020 Contact with and (suspected) exposure to aromatic amines Z77.021 Contact with and (suspected) exposure to benzene Z77.028 Contact with and (suspected) exposure to other hazardous aromatic compounds Z77.09 Contact with and (suspected) exposure to other hazardous, chiefly nonmedicinal, chemicals (non-billable) Z77.090 Contact with and (suspected) exposure to asbestos Z77.098 Contact with and (suspected) exposure to other hazardous, chiefly nonmedicinal, chemicals Z77.1 Contact with and (suspected) exposure to environmental pollution and hazards in the physical environment (non-billable) Z77.11 Contact with and (suspected) exposure to environmental pollution (non-billable) Z77.110 Contact with and (suspected) exposure to air pollution Z77.111 Contact with and (suspected) exposure to water pollution Z77.112 Contact with and (suspected) exposure to soil pollution Z77.118 Contact with and (suspected) exposure to other environmental pollution

ICD-10 Z78.9, Billing FAQ

Is ICD-10 code Z78.9 billable? +

Yes, Z78.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with Z78.9? +

Procedures frequently paired with Z78.9 include: 88120, 86386, 86294, 86316, 88121.

What ICD-9 codes does Z78.9 map to? +

Per CMS GEMs, Z78.9 maps to ICD-9 codes: V4989. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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