Valid for Submission
Z85.09 is a billable code used to specify a medical diagnosis of personal history of malignant neoplasm of other digestive organs. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z85.09 might also be used to specify conditions or terms like h/o: biliary disease, h/o: biliary disease, h/o: gallbladder disease, history of cancer of gall bladder, history of malignant neoplasm of appendix, history of malignant neoplasm of common bile duct, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
The code Z85.09 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: | Z85.09 |
| Short Description: | Personal history of malignant neoplasm of digestive organs |
| Long Description: | Personal history of malignant neoplasm of other digestive organs |
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 Z85.09 are found in the index:
- - History
- - personal (of) - See Also: History, family (of);
- - malignant neoplasm (of) - Z85.9
- - digestive organ - Z85.00
- - specified NEC - Z85.09
- - digestive organ - Z85.00
- - malignant neoplasm (of) - Z85.9
- - personal (of) - See Also: History, family (of);
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: biliary disease
- H/O: biliary disease
- H/O: gallbladder disease
- History of cancer of gall bladder
- History of malignant neoplasm of appendix
- History of malignant neoplasm of common bile duct
Diagnostic Related Groups
The ICD-10 code Z85.09 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 10/01/2020 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)
Z85.09 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 Code | POA Reason for Code | CMS will pay the CC/MCC DRG? |
|---|---|---|
| Y | Diagnosis was present at time of inpatient admission. | YES |
| N | Diagnosis was not present at time of inpatient admission. | NO |
| U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
| W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
| 1 | Unreported/Not used - Exempt from POA reporting. | NO |
Convert Z85.09 to ICD-9
- V10.09 - Hx of GI malignancy NEC (Approximate Flag)
Code Classification
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