2027 ICD-10-CM Diagnosis Code Z19.1Hormone sensitive malignancy status

ICD-10-CM Codes›Z00–Z99›Z19›Z19

ICD-10-CM Z19.1
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Z19.1 is a billable ICD-10-CM diagnosis code for hormone sensitive malignancy status. 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 hormone sensitive prostate cancer. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Genetic susceptibility to disease; and Malignant neoplasm, unspecified.

Code Identity

ICD-10-CM Code
Z19.1
Billable Status
Yes — Valid for Submission
Code Describes
Hormone sensitive malignancy status
Short Description
Hormone sensitive malignancy status
Same as the full description in the CMS dataset.
Parent Code
Z19
Hormone sensitivity malignancy status

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ19Hormone sensitivity malignancy status
CategoryZ19Hormone sensitivity malignancy status
This CodeZ19.1Hormone sensitive malignancy status

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z19.1.

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

Z19.1 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Hormone sensitivity malignancy status (Z19).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Hormone sensitive prostate cancer

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Z19.1: its own notes plus those printed at Z19 and Chapter 21. A note printed at a category, block or chapter applies to every code under it.

Code First

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

From Z19 Hormone sensitivity malignancy status applies to 2 codes
  • malignant neoplasm - see Table of Neoplasms, by site, malignant

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 Z19.1, its category, or a range that includes it.

Use Additional Code 1

These codes say to use an additional code from the note, and Z19.1 is one of the codes named.

  • C61 Malignant neoplasm of prostate
    hormone sensitivity status (Z19.1-Z19.2)

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
CCSR NEO071
Malignant neoplasm, unspecified
Default principal diagnosis: inpatient No · outpatient No

Convert Z19.1 to ICD-9-CMHistory

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

ICD-9-CM
No Map There is no ICD-9 equivalent for this code.

Code History & ChangesHistory

Replacement Z19.1 replaces the following previously assigned code(s):

  • R97.8 - Other abnormal tumor markers
FY 2019AddedAdded to the ICD-10-CM code setEffective October 1, 2018.
FY 2020–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Z19.1Overview

What is the ICD-10 code for hormone sensitive malignancy status?

The ICD-10-CM code for hormone sensitive malignancy status is Z19.1 (sometimes written as Z191). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is Z19.1 (Hormone sensitivity malignancy status) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report hormone sensitive malignancy status on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Z19.1 group to?

On inpatient claims, hormone sensitive malignancy status 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 Z19.1 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because hormone sensitive malignancy status describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Is Z19.1 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 hormone sensitive malignancy status on inpatient claims. The code appears in the Hormone sensitivity malignancy status (Z19) range of the CMS exempt list.