2027 ICD-10-CM Diagnosis Code Z85.040Personal history of malignant carcinoid tumor of rectum

ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z85

ICD-10-CM Z85.040
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Z85.040 is a billable ICD-10-CM diagnosis code for personal history of malignant carcinoid tumor of rectum. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 826 through 830, 843 through 845. 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 history of colorectal neoplasm. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Personal history of malignant neoplasm.

Code Identity

ICD-10-CM Code
Z85.040
Billable Status
Yes — Valid for Submission
Code Describes
Personal history of malignant carcinoid tumor of rectum
Short Description
Personal history of malignant carcinoid tumor of rectum
Same as the full description in the CMS dataset.
Parent Code
Z85.04
Personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ77-Z99Persons with potential health hazards related to family and personal history and certain conditions influencing health status
CategoryZ85Personal history of malignant neoplasm
This CodeZ85.040Personal history of malignant carcinoid tumor of rectum

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z85.040.

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)Billing

Z85.040 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.

  • History of colorectal neoplasm
  • History of malignant neoplasm of cecum and/or colon and/or rectum
  • History of malignant neoplasm of rectum
  • History of well-differentiated neuroendocrine tumor
  • History of well-differentiated neuroendocrine tumor of gastrointestinal tract
  • History of well-differentiated neuroendocrine tumor of rectum

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Z85.040: its own notes plus those printed at Z85, block Z77-Z99, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Z85 Personal history of malignant neoplasm applies to 60 codes
  • personal history of benign neoplasm (Z86.01-)
  • personal history of carcinoma-in-situ (Z86.00-)

Code First

The underlying condition named in the note is sequenced before this code.

From Z85 Personal history of malignant neoplasm applies to 60 codes
  • any follow-up examination after treatment of malignant neoplasm (Z08)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Z85 Personal history of malignant neoplasm applies to 60 codes
  • code to identify:
  • alcohol use and dependence (F10.-)
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From Block Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status applies to 567 codes
  • any follow-up examination (Z08-Z09)

Notes

General instructions on how these codes are used.

From Chapter 21 (Z00-Z99) Factors influencing health status and contact with health services applies to 1,425 codes
  • 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 Z85.040, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming Z85.040: its condition is not part of those codes, and both may be reported when the patient has both.

  • Z86.0 Personal history of in-situ and benign neoplasms and neoplasms of uncertain behavior
    personal history of malignant neoplasms (Z85.-) names Z85.-, which includes this code

Use Additional Code 2

These codes say to use an additional code from the note, and Z85.040 is one of the codes named.

  • Z08 Encounter for follow-up examination after completed treatment for malignant neoplasm
    code to identify the personal history of malignant neoplasm (Z85.-) names Z85.-, which includes this code
  • Z15.0 Genetic susceptibility to malignant neoplasm
    code, if applicable, for any personal history of malignant neoplasm (Z85.-) names Z85.-, which includes this code

Code Also 1

These codes say Z85.040 may also be needed to fully describe the condition. The note gives no sequencing direction.

  • QA1 Genetic disorders associated with neoplasms, not elsewhere classified
    personal history of malignant neoplasm (Z85.-) names Z85.-, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR FAC027
Personal history of malignant neoplasm
Default principal diagnosis: inpatient No · outpatient Yes

Patient EducationClinical

Carcinoid Tumors

Carcinoid tumors are rare, slow-growing cancers. They usually start in the lining of the digestive tract or in the lungs. They grow slowly and don't produce symptoms in the early stages. As a result, the average age of people diagnosed with digestive or lung carcinoids is about 60.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Z85.040 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V10.91 Hx malig neuroendo tumor
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Z85.040Overview

What is the ICD-10 code for personal history of malignant carcinoid tumor of rectum?

The ICD-10-CM code for personal history of malignant carcinoid tumor of rectum is Z85.040 (sometimes written as Z85040). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is Z85.040 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report personal history of malignant carcinoid tumor of rectum on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Z85.040 group to?

On inpatient claims, personal history of malignant carcinoid tumor of rectum maps to MS-DRG 844, 827, 829, 843, 828, 826, 830, 845, with relative weights from 0.8443 to 4.7560 depending on complications. Higher weights mean higher Medicare reimbursement.

Can Z85.040 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because personal history of malignant carcinoid tumor of rectum describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Is Z85.040 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 personal history of malignant carcinoid tumor of rectum 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.