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

ICD-10 Z80.0

Billable / Specific

Family history of malignant neoplasm of digestive organs

Z80
Block
1
Synonyms
62
LCDs
7
Payer Policies
6
Linked CPTs

About ICD-10-CM Z80.0

ICD-10-CM code Z80.0 represents Family history of malignant neoplasm of digestive organs. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z80). The 2026 edition of ICD-10-CM Z80.0 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under Z80.0. Per CMS ICD-10-CM Tabular 2026.

  • Conditions classifiable to C15-C26

Medicare LCD Coverage for Z80.0

Local Coverage Determinations (LCDs) from CMS MACs that list Z80.0 as a covered diagnosis.

62 LCDs

Showing top 10 of 62 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45341 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45331 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45398 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT G9999 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 44392 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45386 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45378 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45305 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45309 →
CMS LCD: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 44390 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Z80.0.

7 policies

2 Cigna

Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530
Preventive Care Services - (A004)
Policy ID: AD_A004

3 Medicare

Billing and Coding: Screening Colonoscopy Converted to a Diagnostic and/or Therapeutic Colonoscopy
Policy ID: ART-55069
Billing and Coding: Incomplete Colonoscopy/Failed Colonoscopy
Policy ID: ART-55227
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56632

2 Aetna

Genetic Counseling
Policy ID: CPB-0189
Colonoscopy, Colorectal Cancer Screening, and Related Procedures
Policy ID: CPB-0516

CPT Codes Commonly Billed with Z80.0

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

6 linkages
  • 45378 Screening colonoscopy — average risk, family history, personal history Gastroenterology
  • 45378 Diagnostic colonoscopy — colorectal screening, family hx colon cancer, polyp, melena, iron def anemia, diverticulosis, ulcerative colitis, Crohn, occult blood, rectal polyp, weight loss, IBS Gastroenterology
  • 45385 Colonoscopy with polypectomy snare — colon polyps all sites, screening, personal/family hx polyps/cancer Gastroenterology
  • G0105 CMS LCD: Billing and Coding: Screening Colonoscopy Converted to a Diagnostic and/or Therapeutic Colonoscopy CMS LCD
  • G2204 CMS LCD: Billing and Coding: Screening Colonoscopy Converted to a Diagnostic and/or Therapeutic Colonoscopy CMS LCD
  • G0121 CMS LCD: Billing and Coding: Incomplete Colonoscopy/Failed Colonoscopy CMS LCD

Convert Z80.0 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
Z80.0 V160 00000

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

Codes Adjacent To Z80.0

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 Z80.0, Billing FAQ

Is ICD-10 code Z80.0 billable? +

Yes, Z80.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to Z80.0? +

ICD-10 Z80.0 includes: Conditions classifiable to C15-C26.

What CPT codes are commonly billed with Z80.0? +

Procedures frequently paired with Z80.0 include: 45378, 45378, 45385, G0105, G2204.

What ICD-9 codes does Z80.0 map to? +

Per CMS GEMs, Z80.0 maps to ICD-9 codes: V160. 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 June 1, 2026.

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