2024 ICD-10-CM Diagnosis Code Z85.3

Personal history of malignant neoplasm of breast

ICD-10-CM Code:
Z85.3
ICD-10 Code for:
Personal history of malignant neoplasm of breast
Is Billable?
Yes - Valid for Submission
Code Navigator:

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)

Z85.3 is a billable diagnosis code used to specify a medical diagnosis of personal history of malignant neoplasm of breast. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

This code 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.

Approximate Synonyms

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

  • History of invasive malignant neoplasm of breast
  • History of malignant neoplasm of breast
  • History of malignant phyllodes neoplasm of breast
  • History of Paget's disease of breast
  • History of recurrent malignant neoplasm of breast
  • Personal history of primary malignant neoplasm of breast

Clinical Classification

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


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 C50

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM 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.

Present on Admission (POA)

Z85.3 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 IndicatorReason 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 Z85.3 to ICD-9-CM

  • ICD-9-CM Code: V10.3 - Hx of breast malignancy

Patient Education


Breast Cancer

What is breast cancer?

Breast cancer is a cancer that starts in breast tissue. It happens when cells in the breast change and grow out of control. The cells usually form a tumor.

Sometimes the cancer does not spread any further. This is called "in situ." If the cancer spreads outside the breast, the cancer is called "invasive." It may just spread to nearby tissues and lymph nodes. Or the cancer may metastasize (spread to other parts of the body) through the lymph system or the blood.

Breast cancer is the second most common type of cancer in women in the United States. Rarely, it can also affect men.

What are the types of breast cancer?

There are different types of breast cancer. The types are based on which breast cells turn into cancer. The types include:

  • Ductal carcinoma, which begins in the cells of the ducts. This is the most common type.
  • Lobular carcinoma, which begins in the lobules. It is more often found in both breasts than other types of breast cancer.
  • Inflammatory breast cancer, in which cancer cells block lymph vessels in the skin of the breast. The breast becomes warm, red, and swollen. This is a rare type.
  • Paget's disease of the breast, which is a cancer involving the skin of the nipple. It usually also affects the darker skin around the nipple. It is also rare.

What causes breast cancer?

Breast cancer happens when there are changes in the genetic material (DNA). Often, the exact cause of these genetic changes is unknown.

But sometimes these genetic changes are inherited, meaning that you are born with them. Breast cancer that is caused by inherited genetic changes is called hereditary breast cancer.

There are also certain genetic changes that can raise your risk of breast cancer, including changes in the BRCA1 and BRCA2 genes. These two changes also raise your risk of ovarian and other cancers.

Besides genetics, your lifestyle and the environment can affect your risk of breast cancer.

Who is at risk for breast cancer?

The factors that raise your risk of breast cancer include:

  • Older age
  • History of breast cancer or benign (noncancer) breast disease
  • Inherited risk of breast cancer, including having BRCA1 and BRCA2 gene changes
  • Dense breast tissue
  • A reproductive history that leads to more exposure to the estrogen hormone, including
    • Menstruating at an early age
    • Being at an older age when you first gave birth or never having given birth
    • Starting menopause at a later age
  • Taking hormone therapy for symptoms of menopause
  • Radiation therapy to the breast or chest
  • Obesity
  • Drinking alcohol

What are the signs and symptoms of breast cancer?

The signs and symptoms of breast cancer include:

  • A new lump or thickening in or near the breast or in the armpit.
  • A change in the size or shape of the breast.
  • A dimple or puckering in the skin of the breast. It may look like the skin of an orange.
  • A nipple turned inward into the breast.
  • Nipple discharge other than breast milk. The discharge might happen suddenly, be bloody, or happen in only one breast.
  • Scaly, red, or swollen skin in the nipple area or the breast
  • Pain in any area of the breast.

How is breast cancer diagnosed?

Your health care provider may use many tools to diagnose breast cancer and figure out which type you have:

  • A physical exam, including a clinical breast exam (CBE). This involves checking for any lumps or anything else that seems unusual with the breasts and armpits.
  • A medical history.
  • Imaging tests, such as a mammogram, an ultrasound, or an MRI.
  • Breast biopsy.
  • Blood chemistry tests, which measure different substances in the blood, including electrolytes, fats, proteins, glucose (sugar), and enzymes. Some of the specific blood chemistry tests include a basic metabolic panel (BMP), a comprehensive metabolic panel (CMP), and an electrolyte panel.

If these tests show that you have breast cancer, you will have tests that study the cancer cells. These tests help your provider decide which treatment would be best for you. The tests may include:

  • Genetic tests for genetic changes such as in the BRCA and TP53 genes.
  • HER2 test. HER2 is a protein involved with cell growth. It is on the outside of all breast cells. If your breast cancer cells have more HER2 than normal, they can grow more quickly and spread to other parts of the body.
  • An estrogen and progesterone receptor test. This test measures the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly.

Another step is staging the cancer. Staging involves doing tests to find out whether the cancer has spread within the breast or to other parts of the body. The tests may include other diagnostic imaging tests and a sentinel lymph node biopsy. This biopsy is done to see whether the cancer has spread to the lymph nodes.

What are the treatments for breast cancer?

Treatments for breast cancer include:

  • Surgery such as
    • A mastectomy, which removes the whole breast
    • A lumpectomy to remove the cancer and some normal tissue around it, but not the breast itself
  • Radiation therapy
  • Chemotherapy
  • Hormone therapy, which blocks cancer cells from getting the hormones they need to grow
  • Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells
  • Immunotherapy

Can breast cancer be prevented?

You may be able to help prevent breast cancer by making healthy lifestyle changes such as:

  • Staying at a healthy weight
  • Limiting alcohol use
  • Getting enough exercisee
  • Limiting your exposure to estrogen by
    • Breastfeeding your babies if you can
    • Limiting hormone therapy

If you are at high risk, your health care provider may suggest that you take certain medicines to lower the risk. Some women at very high risk may decide to get a mastectomy (of their healthy breasts) to prevent breast cancer.

It's also important to get regular mammograms. They may be able to identify breast cancer in the early stages, when it is easier to treat.

NIH: National Cancer Institute


[Learn More in MedlinePlus]

Breast Cancer-Patient Version

Learn about breast cancer risk factors, symptoms, tests to diagnose, factors affecting prognosis, staging, and treatment.
[Learn More in MedlinePlus]

Breast Cancer Summary

Learn about breast cancer risk factors, symptoms, tests to diagnose, factors affecting prognosis, staging, and treatment.
[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.