ICD-10-CM Code Z85.068

Personal history of other malignant neoplasm of small intestine

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z85.068 is a billable code used to specify a medical diagnosis of personal history of other malignant neoplasm of small intestine. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z85.068 might also be used to specify conditions or terms like h/o upper git neoplasm, h/o: biliary disease, history of cancer of ampulla of duodenum, history of malignant neoplasm of duodenum, history of malignant neoplasm of pancreas, history of malignant neoplasm of retroperitoneum, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z85.068 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.

ICD-10:Z85.068
Short Description:Personal history of malignant neoplasm of small intestine
Long Description:Personal history of other malignant neoplasm of small intestine

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Z85.068:

Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • Conditions classifiable to C17

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z85.068 are found in the index:


Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

  • 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.

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • H/O upper GIT neoplasm
  • H/O: biliary disease
  • History of cancer of ampulla of duodenum
  • History of malignant neoplasm of duodenum
  • History of malignant neoplasm of pancreas
  • History of malignant neoplasm of retroperitoneum
  • History of malignant neoplasm of small bowel

Diagnostic Related Groups

The ICD-10 code Z85.068 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2019 through 09/30/2020.

  • 826 - MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURE WITH MCC
  • 827 - MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURE WITH CC
  • 828 - MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURE WITHOUT CC/MCC

Present on Admission (POA)

Z85.068 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Z85.068 to ICD-9

  • V10.09 - Hx of GI malignancy NEC (Approximate Flag)

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
      • Personal history of malignant neoplasm (Z85)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Intestinal Cancer

Your small intestine is part of your digestive system. It is a long tube that connects your stomach to your large intestine. Intestinal cancer is rare, but eating a high-fat diet or having Crohn's disease, celiac disease, or a history of colonic polyps can increase your risk.

Possible signs of small intestine cancer include

  • Abdominal pain
  • Weight loss for no reason
  • Blood in the stool
  • A lump in the abdomen

Imaging tests that create pictures of the small intestine and the area around it can help diagnose intestinal cancer and show whether it has spread.

Surgery is the most common treatment. Additional options include chemotherapy, radiation therapy, or a combination.

NIH: National Cancer Institute


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