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v1.0.0
ICD-10 Guide
ICD-10 CodesZ86

Z86

Personal history of certain other diseases

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 Z86 is a used to indicate a diagnosis of personal history of certain other diseases.

Key Diagnostic Point:

The ICD-10 Level 1 Category code Z86 pertains to the personal history of certain other diseases. This category is designed to capture a patient's past medical history of specific conditions that may not be currently active but could influence future healthcare decisions and risk assessments. Conditions covered under this category include, but are not limited to, previous diagnoses of diseases such as tuberculosis, certain cancers, and other significant health issues that have been resolved or treated. Documenting these conditions is crucial for providing comprehensive patient care and ensuring that healthcare providers are aware of the patient's medical background, which can affect treatment choices and preventive measures.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of conditions covered
  • Potential for overlapping diagnoses
  • Need for accurate patient history documentation

Audit Risk Factors

  • Inaccurate coding of past conditions
  • Failure to document history accurately
  • Misinterpretation of patient history

Specialty Focus

Medical Specialties

Family Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Internal Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related Codes

Child Codes

48 codes
Z86.0
Personal history of in-situ and benign neoplasms and neoplasms of uncertain behavior
Z86.00
Personal history of in-situ neoplasm
Z86.000
Personal history of in-situ neoplasm of breast
Z86.001
Personal history of in-situ neoplasm of cervix uteri
Z86.002
Personal history of in-situ neoplasm of other and unspecified genital organs
Z86.003
Personal history of in-situ neoplasm of oral cavity, esophagus and stomach
Z86.004
Personal history of in-situ neoplasm of other and unspecified digestive organs
Z86.005
Personal history of in-situ neoplasm of middle ear and respiratory system
Z86.006
Personal history of melanoma in-situ
Z86.007
Personal history of in-situ neoplasm of skin
Z86.008
Personal history of in-situ neoplasm of other site
Z86.01
Personal history of benign neoplasm
Z86.010
Personal history of colon polyps
Z86.0100
Personal history of colon polyps, unspecified
Z86.0101
Personal history of adenomatous and serrated colon polyps
Z86.0102
Personal history of hyperplastic colon polyps
Z86.0109
Personal history of other colon polyps
Z86.011
Personal history of benign neoplasm of the brain
Z86.012
Personal history of benign carcinoid tumor
Z86.018
Personal history of other benign neoplasm
Z86.03
Personal history of neoplasm of uncertain behavior
Z86.1
Personal history of infectious and parasitic diseases
Z86.11
Personal history of tuberculosis
Z86.12
Personal history of poliomyelitis
Z86.13
Personal history of malaria
Z86.14
Personal history of Methicillin resistant Staphylococcus aureus infection
Z86.15
Personal history of latent tuberculosis infection
Z86.16
Personal history of COVID-19
Z86.19
Personal history of other infectious and parasitic diseases
Z86.2
Personal history of diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
Z86.3
Personal history of endocrine, nutritional and metabolic diseases
Z86.31
Personal history of diabetic foot ulcer
Z86.32
Personal history of gestational diabetes
Z86.39
Personal history of other endocrine, nutritional and metabolic disease
Z86.5
Personal history of mental and behavioral disorders
Z86.51
Personal history of combat and operational stress reaction
Z86.59
Personal history of other mental and behavioral disorders
Z86.6
Personal history of diseases of the nervous system and sense organs
Z86.61
Personal history of infections of the central nervous system
Z86.69
Personal history of other diseases of the nervous system and sense organs
Z86.7
Personal history of diseases of the circulatory system
Z86.71
Personal history of venous thrombosis and embolism
Z86.711
Personal history of pulmonary embolism
Z86.718
Personal history of other venous thrombosis and embolism
Z86.72
Personal history of thrombophlebitis
Z86.73
Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits
Z86.74
Personal history of sudden cardiac arrest
Z86.79
Personal history of other diseases of the circulatory system

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical and administrative impact of the Z86 code category is significant, as it helps healthcare providers identify patients at risk for certain conditions based on their medical history. This can lead to improved quality measures and better population health management, as providers can implement preventive strategies tailored to individual patient needs. Furthermore, as healthcare trends shift towards value-based care, accurate coding of personal history becomes increasingly important for tracking outcomes and ensuring appropriate resource allocation.

ICD-9 vs ICD-10

The clinical and administrative impact of the Z86 code category is significant, as it helps healthcare providers identify patients at risk for certain conditions based on their medical history. This can lead to improved quality measures and better population health management, as providers can implement preventive strategies tailored to individual patient needs. Furthermore, as healthcare trends shift towards value-based care, accurate coding of personal history becomes increasingly important for tracking outcomes and ensuring appropriate resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, and it is essential to check specific guidelines to ensure compliance. Additionally, common billing practices include using Z86 codes in conjunction with other active diagnosis codes to provide a complete picture of the patient's health status.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for Z86

Coding & Billing References

  • •
    Official ICD-10 Guidelines for Z86

Frequently Asked Questions

What conditions are included in Z86?

Z86 includes a variety of conditions such as personal history of certain cancers, tuberculosis, and other significant diseases that have been resolved. It is important to refer to specific subcategories for detailed conditions.

When should I use Z86 codes?

Z86 codes should be used when documenting a patient's personal history of certain diseases that are no longer active but may impact current health status or treatment decisions.

What documentation is required for Z86?

Documentation for Z86 should include a clear record of the patient's past medical history, including dates of diagnosis, treatment received, and current status of the condition.