The ICD-10 category Z80-Z87 captures codes related to individuals with potential health hazards due to family and personal history, and certain conditions influencing health status. These codes are crucial for documenting patients' past medical conditions or family history of diseases, which may influence their current health status and future medical risk. They are often used in preventative care, risk assessment, and screening procedures.

Key Usage Points:

•Z80 codes are used for family history of malignant neoplasms.
•Z81 codes document family history of mental and behavioral disorders.
•Z82 codes capture family history of certain disabilities and chronic diseases.
•Z83-Z84 codes are used for family history of other specific disorders.
•Z85-Z87 codes document personal history of diseases.

Coding Guidelines

When to Use:

✓When a patient has a family history of breast cancer, use Z80.3.
✓For a patient with a personal history of malignant neoplasm of colon, use Z85.038.
✓If a patient's parent has Alzheimer's, use Z81.8.
✓For a patient with a personal history of peptic ulcer disease, use Z87.11.

When NOT to Use:

✗Do not use Z80-Z87 codes for current, active diseases.
✗Avoid using these codes for conditions not influencing the patient's health status.
✗Do not use for patients without any significant family or personal medical history.
✗Avoid using these codes for conditions already captured by other specific codes.

Code Exclusions

Always verify exclusions against the latest ICD-10-CM Official Guidelines for Coding and Reporting.

Documentation Requirements

Documentation for Z80-Z87 codes should clearly state the specific condition or disease in the patient's family or personal history. It should also indicate how this history influences the patient's current health status or treatment plan.

Clinical Information:

•Specific condition or disease in family or personal history
•Relation of the family member with the disease
•Influence of this history on current health status
•Relevance to the patient's treatment plan

Supporting Evidence:

•Medical records from family members
•Previous medical reports of the patient
•Genetic test results

Good Documentation Example:

Patient has a family history of colon cancer, with his father diagnosed at age 45. This history necessitates early and regular colonoscopy screenings.

Poor Documentation Example:

Patient's father had cancer.

Common Documentation Errors:

⚠Vague documentation of the disease in history
⚠Failure to document the influence on current health status
⚠Not specifying the relationship of the family member

Range Statistics

Total Codes

150

Billable

Complexity:

Medium

Primary Use:Clinical Documentation

Chapter:21

Coding Complexity

Medium

Complexity Rating

The complexity of Z80-Z87 coding lies in accurately identifying the specific condition in the patient's history, understanding its influence on the patient's health status and treatment plan, and navigating the various exclusions and specific codes.

Key Factors:

▸Identifying the specific condition in history
▸Determining the relevance to current health status
▸Navigating exclusions and specific codes
▸Understanding the influence on treatment plan

Specialty Focus

Z80-Z87 codes are particularly relevant in specialties like family medicine, internal medicine, and genetics, where family and personal history significantly influence patient care.

Primary Specialties:

Family Medicine

40%

Internal Medicine

30%

Genetics

30%

Clinical Scenarios:

• A 35-year-old woman with a family history of early-onset breast cancer
• A 50-year-old man with a personal history of peptic ulcer disease
• A 30-year-old woman with a family history of Huntington's disease
• A 60-year-old man with a personal history of colon cancer

Resources & References

Numerous resources are available for mastering Z80-Z87 coding, including the ICD-10-CM Official Guidelines, clinical coding tools, and educational materials.

Official Guidelines:

ICD-10-CM Official Guidelines for Coding and Reporting
American Health Information Management Association (AHIMA) guidelines
Centers for Medicare & Medicaid Services (CMS) guidelines

Clinical References:

UpToDate
Medscape

Educational Materials:

AHIMA ICD-10-CM training materials
AAPC coding webinars

Frequently Asked Questions

Can Z80-Z87 codes be used as primary diagnosis?

Yes, Z80-Z87 codes can be used as primary diagnosis when the patient's visit is specifically for the management of the potential health hazard related to their family or personal history.