2026 ICD-10-CM Diagnosis Code Z85.818Personal history of malignant neoplasm of other sites of lip, oral cavity, and pharynx
Z85.818 is a billable ICD-10-CM diagnosis code for personal history of malignant neoplasm of other sites of lip, oral cavity, and pharynx. 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Personal history of malignant neoplasm.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z85.818.
Present on Admission (POA)Billing
Z85.818 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.
- H/O Malignant melanoma
- History of cancer of floor of mouth
- History of carcinoma of lip
- History of malignant neoplasm of gum
- History of malignant neoplasm of hypopharynx
- History of malignant neoplasm of lip
- History of malignant neoplasm of nasopharynx
- History of malignant neoplasm of neck
- History of malignant neoplasm of oral cavity
- History of malignant neoplasm of oropharynx
- History of malignant neoplasm of parotid gland
- History of malignant neoplasm of pharynx
- History of malignant neoplasm of salivary gland
- History of malignant neoplasm of tonsil
- History of nasopharyngeal carcinoma
- History of primary malignant melanoma of oral mucous membrane
- History of primary malignant neoplasm of ear, nose and/or throat
- History of primary malignant neoplasm of oropharynx
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
- History
- personal (of) - See Also: History, family (of);
- malignant neoplasm (of) - Z85.9
- oral cavity - Z85.819
- specified site NEC - Z85.818
- specified site NEC - Z85.818
External Cause of Injuries IndexGuidance
References for this code in the External Cause of Injuries Index.
- History
- personal (of)
- malignant neoplasm (of)
- oral cavity
- specified site NEC
- History
- personal (of)
- malignant neoplasm (of)
- pharynx
- specified site NEC
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
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.
The full article covers:
- What is oral cancer?
- Who is more likely to develop oral cancer?
- What are the symptoms of oral cancer?
- How is oral cancer diagnosed?
- What are the treatments for oral cancer?
- Can oral cancer be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z85.818 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z85.818Overview
Is Z85.818 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report personal history of malignant neoplasm of other sites of lip, oral cavity, and pharynx on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does Z85.818 group to?
On inpatient claims, personal history of malignant neoplasm of other sites of lip, oral cavity, and pharynx 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 Z85.818 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because personal history of malignant neoplasm of other sites of lip, oral cavity, and pharynx describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z85.818 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 other sites of lip, oral cavity, and pharynx on inpatient claims.
What is the ICD-9 equivalent of Z85.818?
Under the General Equivalence Mappings, personal history of malignant neoplasm of other sites of lip, oral cavity, and pharynx converts to ICD-9-CM V10.02 (hx-oral/pharynx malg NEC). The mapping is approximate, so confirm the match fits the documentation.
