2027 ICD-10-CM Diagnosis Code Z15.01Genetic susceptibility to malignant neoplasm of breast

ICD-10-CM Codes›Z00–Z99›Z14-Z15›Z15

ICD-10-CM Z15.01
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Z15.01 is a billable ICD-10-CM diagnosis code for genetic susceptibility to malignant neoplasm of breast. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. Coders also document this condition as BRCA1 gene mutation detected. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Genetic susceptibility to disease.

Code Identity

ICD-10-CM Code
Z15.01
Billable Status
Yes — Valid for Submission
Code Describes
Genetic susceptibility to malignant neoplasm of breast
Short Description
Genetic susceptibility to malignant neoplasm of breast
Same as the full description in the CMS dataset.
Parent Code
Z15.0
Genetic susceptibility to malignant neoplasm

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ14-Z15Genetic carrier and genetic susceptibility to disease
CategoryZ15Genetic susceptibility to disease
This CodeZ15.01Genetic susceptibility to malignant neoplasm of breast

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z15.01.

Unacceptable principal diagnosis
There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Present on Admission (POA)Billing

Z15.01 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Genetic carrier and genetic susceptibility to disease (Z14-Z15).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • BRCA1 gene mutation detected
  • BRCA2 gene mutation detected
  • Breast cancer genetic marker of susceptibility detected
  • Genetic susceptibility to cancer
  • Li-Fraumeni syndrome

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Z15.01: its own notes plus those printed at Z15.0, Z15, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Z15 Genetic susceptibility to disease applies to 14 codes
  • confirmed abnormal gene

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From Z15 Genetic susceptibility to disease applies to 14 codes
  • chromosomal anomalies (Q90-Q99)

Code First

The underlying condition named in the note is sequenced before this code.

From Z15.0 Genetic susceptibility to malignant neoplasm applies to 9 codes
  • if applicable, any current malignant neoplasm (C00-C75, C81-C96)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Z15.0 Genetic susceptibility to malignant neoplasm applies to 9 codes
  • code, if applicable, for any personal history of malignant neoplasm (Z85.-)
From Z15 Genetic susceptibility to disease applies to 14 codes
  • code, if applicable, for any associated family history of the disease (Z80-Z84)

Notes

General instructions on how these codes are used.

From Chapter 21 (Z00-Z99) Factors influencing health status and contact with health services applies to 1,425 codes
  • Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
  • (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
  • (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name Z15.01, its category, or a range that includes it.

Use Additional Code 2

These codes say to use an additional code from the note, and Z15.01 is one of the codes named.

  • Z40.0 Encounter for prophylactic surgery for risk factors related to malignant neoplasms
    code to identify risk factor, such as genetic susceptibility to malignant neoplasm Z15.- names Z15.-, which includes this code
  • Z79.81 Long term (current) use of agents affecting estrogen receptors and estrogen levels
    genetic susceptibility to malignant neoplasm (cancer) (Z15.0-) names Z15.0-, which includes this code

Code Also 2

These codes say Z15.01 may also be needed to fully describe the condition. The note gives no sequencing direction.

  • Q85.81 PTEN hamartoma tumor syndrome
    if applicable, genetic susceptibility to malignant neoplasm (Z15.0-) names Z15.0-, which includes this code
  • QA1 Genetic disorders associated with neoplasms, not elsewhere classified
    genetic susceptibility to malignant neoplasm by site (Z15.0-) names Z15.0-, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR FAC029
Genetic susceptibility to disease
Default principal diagnosis: inpatient No · outpatient No

Patient EducationClinical

Breast cancer

Breast cancer is a disease in which certain cells in the breast become abnormal and multiply uncontrollably to form a tumor. Although breast cancer is much more common in women, this form of cancer can also develop in men. In both women and men, the most common form of breast cancer begins in cells lining the milk ducts (ductal cancer).

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Z15.01 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V84.01 Genetc sus mal neo brest
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Z15.01Overview

What is the ICD-10 code for genetic susceptibility to malignant neoplasm of breast?

The ICD-10-CM code for genetic susceptibility to malignant neoplasm of breast is Z15.01 (sometimes written as Z1501). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is Z15.01 (Genetic susceptibility to malignant neoplasm) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report genetic susceptibility to malignant neoplasm of breast on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Z15.01 group to?

On inpatient claims, genetic susceptibility to malignant neoplasm of breast maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.

Can Z15.01 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because genetic susceptibility to malignant neoplasm of breast describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Is Z15.01 exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for genetic susceptibility to malignant neoplasm of breast on inpatient claims. The code appears in the Genetic carrier and genetic susceptibility to disease (Z14-Z15) range of the CMS exempt list.