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ICD-10-CM Z85.9: Personal history of malignant neoplasm, unspecified

Z85.9 is the billable ICD-10-CM code for personal history of malignant neoplasm, unspecified, in category Z85 (Personal history of malignant neoplasm) of the Persons with potential health hazards related to family and personal history and certain conditions influencing health status section. As a principal diagnosis it groups to MS-DRG 826 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with MCC, MS-DRG 827 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with CC, MS-DRG 828 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures without CC/MCC (MDC 17 MDC 17: Myeloproliferative Diseases and Disorders, Poorly Differentiated Neoplasms). 4 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
Z85.9
billable FY2027 ICD-10-CM code
Category
Z85 Personal history of malignant neoplasm
Chapter
21: Factors influencing health status and contact with health services (Z00-Z99)
CC/MCC (MS-DRG v44)
Neither
CMS-HCC V28
Not mapped
POA reporting
Exempt

Tabular list notes for Z85.9

The tabular list has no notes on Z85.9 itself; the notes below apply from its parent headings.

Inherited from Z85 (Personal history of malignant neoplasm)

Excludes2 (not part of this condition, may be coded together)
  • personal history of benign neoplasm (Z86.01-)
  • personal history of carcinoma-in-situ (Z86.00-)
Code first
  • any follow-up examination after treatment of malignant neoplasm (Z08)
Use additional code
  • code to identify:
  • alcohol use and dependence (F10.-)
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

MS-DRG grouping when Z85.9 is the principal diagnosis

MS-DRG v44 groups for Z85.9 as principal diagnosis
MDCMS-DRGs
17 MDC 17: Myeloproliferative Diseases and Disorders, Poorly Differentiated Neoplasms826827828829830843844845

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for Z85.9 shows the full grouping logic.

CC/MCC status and inpatient edits

Z85.9 is neither a CC nor an MCC under MS-DRG v44, so as a secondary diagnosis it does not raise the MS-DRG severity level. Check Z85.9 against a principal diagnosis.

  • Present on admission: exempt from POA indicator reporting (FY2027 exempt list).
  • Medicare Code Editor: unacceptable principal diagnosis.

CMS-HCC V28 risk adjustment

Z85.9 does not map to a payment HCC in the PY2027 CMS-HCC V28 model, so on its own it does not change a Medicare Advantage risk score.

LCD billing and coding articles that list Z85.9

4 current Medicare billing and coding articles list Z85.9 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM Z85.9 mean?

Z85.9 means personal history of malignant neoplasm, unspecified. It is one of 25 billable codes under Z85, personal history of malignant neoplasm.

Which MS-DRG does Z85.9 group to?

As the principal diagnosis, Z85.9 groups to MS-DRG 826 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with MCC, MS-DRG 827 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with CC, MS-DRG 828 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures without CC/MCC (MDC 17 MDC 17: Myeloproliferative Diseases and Disorders, Poorly Differentiated Neoplasms) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.