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Z85.22 ICD-10-CM Code: Personal history of malignant neoplasm of nasal cavities, middle ear, and accessory sinuses

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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)

Z85.22

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Personal history of malignant neoplasm of nasal cavities, middle ear, and accessory sinuses

A patient who previously had cancer in the nasal passages, middle ear, or sinuses but is no longer being treated for it.

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
Z85Personal history of malignant neoplasm
Z85.2Personal history of malignant neoplasm of other respiratory and intrathoracic organs
Z85.22Personal history of malignant neoplasm of nasal cavities, middle ear, and accessory sinuses

Inclusion Terms

Official
  • Conditions classifiable to C30-C31

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for Z85.22 in this effective period.

Related Child Codes

Official
Z85.20Personal history of malignant neoplasm of unspecified respiratory organ
Z85.21Personal history of malignant neoplasm of larynx
Z85.23Personal history of malignant neoplasm of thymus
Z85.29Personal history of malignant neoplasm of other respiratory and intrathoracic organs

Includes

Official

ICD-10-CM does not list Includes notes for Z85.22 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for Z85.22 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for Z85.22 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for Z85.22 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for Z85.22 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
This code encompasses multiple anatomical sites in the head and neck region; document the specific site if known.
Verify the cancer is in remission or resolved before assigning this history code.

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.

Is Z85.22 an HCC code?

No. Z85.22 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

Z85.22 is the ICD-10-CM diagnosis code for personal history of malignant neoplasm of nasal cavities, middle ear, and accessory sinuses. A patient who previously had cancer in the nasal passages, middle ear, or sinuses but is no longer being treated for it. Z85.22 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).

Z85.22 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

This code encompasses multiple anatomical sites in the head and neck region; document the specific site if known.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z85.22 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This code encompasses multiple anatomical sites in the head and neck region; document the specific site if known.
  • Verify the cancer is in remission or resolved before assigning this history code.

Child Codes

Code Hierarchy

More on Z85.22

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