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

ICD-10 Z86.16

Billable / Specific

Personal history of COVID-19

Z86
Block
0
Synonyms
37
LCDs
1
Payer Policies
0
Linked CPTs

About ICD-10-CM Z86.16

ICD-10-CM code Z86.16 represents Personal history of COVID-19. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z86). The 2026 edition of ICD-10-CM Z86.16 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with Z86.16. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • post COVID-19 condition (U09.9)

Medicare LCD Coverage for Z86.16

Local Coverage Determinations (LCDs) from CMS MACs that list Z86.16 as a covered diagnosis.

37 LCDs

Showing top 10 of 37 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94660 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94726 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94664 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94618 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94772 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94642 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT G0238 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94004 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94668 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94680 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Z86.16.

1 policies

1 Medicare

Billing and Coding: Respiratory Care
Policy ID: ART-57224

CPT Codes Commonly Billed with Z86.16

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

No procedure linkages on file for Z86.16

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 Z86.16

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 Z86.16, Billing FAQ

Is ICD-10 code Z86.16 billable? +

Yes, Z86.16 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for Z86.16? +

Type 1 Excludes (never code together with Z86.16): post COVID-19 condition (U09.9)

Get the full PayerReady toolkit

Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.

Start free →

Run this code through our claim audit tool

Check NCCI bundling, MUE limits, and modifier logic before submission.

Try the auditor →

Did this page help?

Quick signal so we know what to improve.

Thanks!

If you want a code reference page that doesn't exist yet, email coding@payerready.com.

Sorry to hear that.

Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.

Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team

Faster Approvals

Ready to Cut Your Enrollment Timeline in Half?

Join providers in all 50 states who handed off credentialing to a dedicated specialist. Create your free account in minutes and start enrolling the same day.

Get Started Today Request a Demo
All 50 States Covered
No Long-Term Contracts
HIPAA HIPAA Compliant Platform
Dedicated Specialist Included