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ICD-10 Guide
ICD-10 CodesChapter 21: Factors influencing health statusZ87

Z87

Non-billable

Personal history of other diseases and conditions

Chapter 21:Factors influencing health status

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

Code Description

ICD-10 Z87 is a used to indicate a diagnosis of personal history of other diseases and conditions.

Key Diagnostic Point:

The ICD-10 Level 1 Category code Z87 pertains to personal history of other diseases and conditions. This category is used to indicate a patient's past medical history of conditions that may not currently be active but could influence future healthcare decisions. It encompasses a variety of conditions, including but not limited to, previous surgeries, chronic illnesses that have resolved, and other significant health events that may impact the patient's ongoing care. Proper documentation of these conditions is crucial for comprehensive patient management and can influence treatment plans and preventive measures.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of conditions covered
  • Need for accurate historical documentation
  • Potential for overlap with other categories

Audit Risk Factors

  • Inaccurate historical documentation
  • Failure to update patient history
  • Misuse of codes leading to incorrect billing

Specialty Focus

Medical Specialties

Primary Care

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 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 Z87 code category is significant, as it provides healthcare providers with essential information about a patient's past health issues that may influence current treatment plans. Accurate coding of personal history can enhance quality measures by ensuring that preventive care is tailored to the patient's unique health background. Furthermore, as healthcare trends move towards value-based care, understanding a patient's history through Z87 codes can improve population health management by identifying at-risk patients and implementing appropriate interventions.

ICD-9 vs ICD-10

The clinical and administrative impact of the Z87 code category is significant, as it provides healthcare providers with essential information about a patient's past health issues that may influence current treatment plans. Accurate coding of personal history can enhance quality measures by ensuring that preventive care is tailored to the patient's unique health background. Furthermore, as healthcare trends move towards value-based care, understanding a patient's history through Z87 codes can improve population health management by identifying at-risk patients and implementing appropriate interventions.

Reimbursement & Billing Impact

reimbursement. It is important to include detailed notes in the patient's medical record that outline the history of the conditions coded under Z87, as this can impact the overall billing process and reimbursement rates. Additionally, coding professionals should stay updated on payer policies regarding the use of personal history codes to ensure compliance and optimize revenue cycle management.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for Z87

Coding & Billing References

  • •
    Official ICD-10 Guidelines for Z87

Frequently Asked Questions

What conditions are included in Z87?

Z87 includes a wide range of conditions such as previous cancers, resolved infections, past surgeries, and any other significant health issues that have been treated or resolved but may still impact the patient's health.

When should I use Z87 codes?

Z87 codes should be used when documenting a patient's past medical history that is relevant to their current health status or treatment plan, particularly when these conditions could affect future healthcare decisions.

What documentation is required for Z87?

Documentation should clearly indicate the condition's resolution status, the date of resolution, and any ongoing implications for the patient's health. This may include notes from previous encounters, surgical reports, or discharge summaries.