ICD-10 Z86.010
Non-Billable HeaderPersonal history of colon polyps
About ICD-10-CM Z86.010
ICD-10-CM code Z86.010 represents Personal history of colon polyps. This is a non-billable header code in the Factors Influencing Health Status chapter (block Z86). The 2026 edition of ICD-10-CM Z86.010 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under Z86.010. Per CMS ICD-10-CM Tabular 2026.
- Personal history of colorectal polyps
- Personal history of rectal polyps
Medicare LCD Coverage for Z86.010
Local Coverage Determinations (LCDs) from CMS MACs that list Z86.010 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 Z86.010.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Z86.010 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Z86.010
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 45378 Screening colonoscopy — average risk, family history, personal history Gastroenterology
Convert Z86.010 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| Z86.010 | V1272 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Z86.010
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 Z86.010, Billing FAQ
Is ICD-10 code Z86.010 billable? +
No, Z86.010 is a non-billable header code. Use a more specific child code from block Z86 when submitting claims.
What other names or terms map to Z86.010? +
ICD-10 Z86.010 includes: Personal history of colorectal polyps; Personal history of rectal polyps.
What CPT codes are commonly billed with Z86.010? +
Procedures frequently paired with Z86.010 include: 45378.
What ICD-9 codes does Z86.010 map to? +
Per CMS GEMs, Z86.010 maps to ICD-9 codes: V1272. 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 2, 2026.
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