Z85 ICD-10-CM Code: Personal history of malignant neoplasm
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
Z85
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidancePersonal history of malignant neoplasm
Personal history of malignant neoplasm
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for Z85 in this effective period.
Excludes 2
Official- personal history of benign neoplasm (Z86.01-)
- personal history of carcinoma-in-situ (Z86.00-)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z85 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Z85 in this effective period.
Code First
Official- any follow-up examination after treatment of malignant neoplasm (Z08)
Use Additional
Official- 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)
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z85 in this effective period.
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Coder workflow notes
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What This Code Means
Z85 is the ICD-10-CM diagnosis code for personal history of malignant neoplasm. Z85 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons with potential health hazards related to family and personal history and certain conditions influencing health status (z77-z99).
Header codes like Z85 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at Z85's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z85 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Excludes 2, Not included here, may code separately
Use Additional Code
Code First
- any follow-up examination after treatment of malignant neoplasm (Z08)