2026 ICD-10-CM Diagnosis Code Z85.3Personal history of malignant neoplasm of breast

ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z85

ICD-10-CM Z85.3
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z85.3 is a billable ICD-10-CM diagnosis code for personal history of malignant neoplasm of breast. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) 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 invasive malignant neoplasm of breast. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Personal history of malignant neoplasm.

Code Identity

ICD-10-CM Code
Z85.3
Billable Status
Yes — Valid for Submission
Code Describes
Personal history of malignant neoplasm of breast
Short Description
Personal history of malignant neoplasm of breast
Same as the full description in the CMS dataset.
Parent Code
Z85
Personal history of malignant neoplasm

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 CodeZ85.3Personal history of malignant neoplasm of breast

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z85.3.

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

Z85.3 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this 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

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Conditions classifiable to C50

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • History
      • personal (of)
        • malignant neoplasm (of)
          • breast

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

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. New cells grow even when you don't need them, and old cells don't die when they should. These extra cells can form a mass called a tumor.

The full article covers:

  • What is breast cancer?
  • What are the types of breast cancer?
  • What causes breast cancer?
  • Who is at risk for breast cancer?
  • What are the signs and symptoms of breast cancer?
  • How is breast cancer diagnosed?
  • What are the treatments for breast cancer?
  • Can breast cancer be prevented?

Read the full article at MedlinePlus

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

Convert Z85.3 to ICD-9-CMHistory

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

ICD-9-CM
V10.3 Hx of breast malignancy
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z85.3Overview

Is Z85.3 (Personal history of malignant neoplasm) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report personal history of malignant neoplasm of breast on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Z85.3 group to?

On inpatient claims, personal history of malignant neoplasm of breast maps to MS-DRG 826, 827, 828, 829, 830, 843, 844, 845, with relative weights from 0.8516 to 4.6778 depending on complications. Higher weights mean higher Medicare reimbursement.

Can Z85.3 be a principal diagnosis?

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

Is Z85.3 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 neoplasm of breast on inpatient claims.

What is the ICD-9 equivalent of Z85.3?

Under the General Equivalence Mappings, personal history of malignant neoplasm of breast converts to ICD-9-CM V10.3 (hx of breast malignancy). The mapping is a direct match.