Z86.711 ICD-10-CM Code: Personal history of pulmonary embolism
Z86.711 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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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)
Z86.711
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePersonal history of pulmonary embolism
A patient has experienced a blood clot in the lungs (pulmonary embolism) in the past that has resolved.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Conditions classifiable to I00-I99Inherited from Z86.7
Excludes 2
Official- old myocardial infarction (I25.2)Inherited from Z86.7
- personal history of anaphylactic shock (Z87.892)Inherited from Z86.7
- postmyocardial infarction syndrome (I24.1)Inherited from Z86.7
Related Codes
Includes
OfficialNo Includes notes are included in this display for Z86.711. Check the code and parent instructions in the Code Book.
Excludes 1
OfficialNo Excludes 1 notes are included in this display for Z86.711. Check the code and parent instructions in the Code Book.
Code First
Official- any follow-up examination after treatment (Z09)Inherited from Z86
Use Additional
OfficialNo Use Additional Code instructions are included in this display for Z86.711. Check the code and parent instructions in the Code Book.
Code Also
Official- any follow-up examination (Z08-Z09)Inherited from Z77-Z99
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is Z86.711 an HCC code?
No. Z86.711 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- Z86.711
- Description
- Personal history of pulmonary embolism
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Z86.711 is the ICD-10-CM diagnosis code for personal history of pulmonary embolism. A patient has experienced a blood clot in the lungs (pulmonary embolism) in the past that has resolved. Z86.711 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).
Z86.711 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
This code is for history only; if the patient currently has a pulmonary embolism, use an active PE code instead.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for Z86.711 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code is for history only; if the patient currently has a pulmonary embolism, use an active PE code instead
- •Document whether the patient is on anticoagulation therapy and any risk factors for recurrence