ICD-10 Z85
Non-Billable HeaderPersonal history of malignant neoplasm
About ICD-10-CM Z85
ICD-10-CM code Z85 represents Personal history of malignant neoplasm. This is a non-billable header code in the Factors Influencing Health Status chapter (block Z85). The 2026 edition of ICD-10-CM Z85 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 2 Excludes
Not included here, the excluded code is not part of Z85, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- personal history of benign neoplasm (Z86.01-)
- personal history of carcinoma-in-situ (Z86.00-)
Use Additional Code
When coding Z85, also report these additional codes when applicable.
- code to identify:
- alcohol use and dependence (F10.-)
- exposure to environmental tobacco smoke (Z77.22)
- history of tobacco dependence (Z87.891)
- occupational exposure to environmental tobacco smoke (Z57.31)
- tobacco dependence (F17.-)
- tobacco use (Z72.0)
Coding Notes
Code First
- any follow-up examination after treatment of malignant neoplasm (Z08)
Medicare LCD Coverage for Z85
Local Coverage Determinations (LCDs) from CMS MACs that list Z85 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Z85.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Z85 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Z85
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To Z85
Other codes in section Z77-Z99 (Persons with potential health hazards related to family and personal history and certain conditions influencing health status).
ICD-10 Z85, Billing FAQ
Is ICD-10 code Z85 billable? +
No, Z85 is a non-billable header code. Use a more specific child code from block Z85 when submitting claims.
What codes are Type 2 Excludes for Z85? +
Type 2 Excludes (may be coded together when both conditions exist): personal history of benign neoplasm (Z86.01-); personal history of carcinoma-in-situ (Z86.00-)
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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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