Z86.000 ICD-10-CM Code: Personal history of in-situ neoplasm of breast
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)
Z86.000
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePersonal history of in-situ neoplasm of breast
A patient who previously had an early-stage, non-invasive cancer of the breast (carcinoma in-situ) that was treated and is no longer active.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
Official- Conditions classifiable to D05
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Z86.000 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z86.000 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Z86.000 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z86.000 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z86.000 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z86.000 in this effective period.
Buddy Documentation Tip
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 Z86.000 an HCC code?
No. Z86.000 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
Get the V28 RAF + MEAT cheat sheet
One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.
Free PDF. No card. Unsubscribe anytime.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Z86.000 is the ICD-10-CM diagnosis code for personal history of in-situ neoplasm of breast. A patient who previously had an early-stage, non-invasive cancer of the breast (carcinoma in-situ) that was treated and is no longer active. Z86.000 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).
Z86.000 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.
In-situ neoplasms are pre-cancerous or early cancers that have not invaded surrounding tissue.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z86.000 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •In-situ neoplasms are pre-cancerous or early cancers that have not invaded surrounding tissue
- •This code indicates the condition was treated; distinguish from active in-situ neoplasm codes