2024 ICD-10-CM Diagnosis Code Z85.819

Personal history of malignant neoplasm of unspecified site of lip, oral cavity, and pharynx

ICD-10-CM Code:
Z85.819
ICD-10 Code for:
Prsnl hx of malig neoplm of unsp site lip,oral cav,& pharynx
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)

Z85.819 is a billable diagnosis code used to specify a medical diagnosis of personal history of malignant neoplasm of unspecified site of lip, oral cavity, and pharynx. 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.

Unspecified diagnosis codes like Z85.819 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Approximate Synonyms

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

  • History of malignant neoplasm of oral cavity

Clinical Classification

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)

Z85.819 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 Z85.819 to ICD-9-CM

  • ICD-9-CM Code: V10.02 - Hx-oral/pharynx malg NEC
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education


Oral Cancer

What is oral cancer?

Oral cancer is cancer of the mouth. It is a type of head and neck cancer. Most oral cancers are squamous cell cancers. They begin in the flat cells that cover the surfaces of your mouth, tongue, and lips. The cancer cells may spread into deeper tissue as the cancer grows.

Most oral cancers are related to tobacco use, heavy alcohol use, or an HPV infection.

Who is more likely to develop oral cancer?

Anyone can get oral cancer, but you are more likely to develop it if you:

  • Use tobacco or drink lots of alcohol. Your risk of developing oral cancer is even higher if you do both.
  • Are male.
  • Are over ago 40.
  • Have HPV.
  • Have a history of head or neck cancer.
  • Get frequent sun exposure (for lip cancer).

What are the symptoms of oral cancer?

The symptoms of oral cancer may include:

  • A white or red patch in your mouth
  • A lip or mouth sore that won't heal
  • Bleeding, pain, or numbness in the lip or mouth
  • Loose teeth or dentures that no longer fit well
  • Problems or pain with swallowing
  • A lump in your neck
  • Ear pain
  • Trouble moving your mouth or jaw
  • Swelling of the jaw
  • A sore throat or feeling that something is caught in the throat

If you have any of these symptoms for more than two weeks, see your health care provider or dentist. Oral cancer can spread quickly, so it's important to find it early.

How is oral cancer diagnosed?

To find out if you have oral cancer, your provider may use:

  • A physical exam of the lips and mouth.
  • An endoscopy.
  • A biopsy or other procedure to collect cells from the lip or oral cavity. The cells are viewed under a microscope to find out if they are abnormal.
  • Imaging tests.

What are the treatments for oral cancer?

The treatments for oral cancer include surgery, radiation therapy, or both. After surgery, some people also need chemotherapy to kill any cancer cells that are left.

Can oral cancer be prevented?

There are steps you can take to help prevent oral cancer:

  • Not smoking
  • Limiting alcohol use or not drinking at all
  • Getting regular dental exams

NIH: National Cancer Institute


[Learn More in MedlinePlus]

Throat Cancer

Throat cancer is a type of head and neck cancer. Throat cancer has different names, depending on which part of the throat is affected. The different parts of your throat are called the oropharynx, the hypopharynx, the nasopharynx, and the larynx, or voice box.

The main risk factors for throat cancer are using tobacco heavy drinking. Certain types of throat cancer also have other risk factors. For example, having HPV is a risk factor for oropharyngeal cancer.

Symptoms of throat cancer may include:

  • A sore throat that does not go away
  • A lump in the neck
  • Pain or ringing in the ears
  • Trouble swallowing
  • Ear pain

To diagnose throat cancers, doctors may do a physical exam and history, imaging tests, and a biopsy. You may also need other tests, depending on the type of cancer. Treatments include surgery, radiation therapy, and chemotherapy. Treatment for some types of throat cancer may also include targeted therapy. Targeted therapy uses drugs or other substances that attack specific cancer cells with less harm to normal cells.

NIH: National Cancer Institute


[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.