2027 ICD-10-CM Diagnosis Code Z84.81Family history of carrier of genetic disease
Z84.81 is a billable ICD-10-CM diagnosis code for family history of carrier of genetic disease. 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 family history of breast cancer 1 gene mutation. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Family history of disease.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z84.81.
Present on Admission (POA)Billing
Z84.81 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Family history of breast cancer 1 gene mutation
- Family history of breast cancer 2 gene mutation
- Family history of breast cancer gene BRCA mutation
- Family history of breast cancer gene mutation in first degree relative
- Family history of gene mutation
- Family history of genetic disorder carrier
- Family history of genetic mutation for hereditary nonpolyposis colon cancer
- Family history of genetic mutation for Lynch syndrome
- Family history of hereditary disease
- Family history of hereditary disease carrier state
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z84.81: its own notes plus those printed at block Z77-Z99 and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Notes
General instructions on how these codes are used.
- 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 Z84.81, its category, or a range that includes it.
Use Additional Code 1
These codes say to use an additional code from the note, and Z84.81 is one of the codes named.
- Z15 Genetic susceptibility to disease
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
family (of) See Also: History, personal (of);
carrier of genetic disease Z84.81
genetic disease carrier Z84.81
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Family History
Your family history includes health information about you and your close relatives. Families have many factors in common, including their genes, environment, and lifestyle. Looking at these factors can help you figure out whether you have a higher risk for certain health problems, such as heart disease, stroke, and cancer.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z84.81 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z84.81Overview
What is the ICD-10 code for family history of carrier of genetic disease?
The ICD-10-CM code for family history of carrier of genetic disease is Z84.81 (sometimes written as Z8481). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z84.81 (Family history of other specified conditions) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report family history of carrier of genetic disease on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z84.81 group to?
On inpatient claims, family history of carrier of genetic disease 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 Z84.81 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because family history of carrier of genetic disease describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z84.81 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 family history of carrier of genetic disease on inpatient claims. The code appears in the Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99) range of the CMS exempt list.
