2024 ICD-10-CM Diagnosis Code Z86.003

Personal history of in-situ neoplasm of oral cavity, esophagus and stomach

ICD-10-CM Code:
Z86.003
ICD-10 Code for:
Pers hx of in-situ neoplm of oral cavity, esoph and stomach
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 certain other diseases
        (Z86)

Z86.003 is a billable diagnosis code used to specify a medical diagnosis of personal history of in-situ neoplasm of oral cavity, esophagus and stomach. 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.

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 D00

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)

Z86.003 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

Replacement Code

Z86003 replaces the following previously assigned ICD-10-CM code(s):

  • Z86.008 - Personal history of in-situ neoplasm of other site

Patient Education


Esophageal Cancer

The esophagus is a hollow tube that carries food and liquids from your throat to your stomach. Early esophageal cancer usually does not cause symptoms. Later, you may have symptoms such as:

  • Painful or difficult swallowing
  • Weight loss
  • A hoarse voice or cough that doesn't go away

You're at greater risk for getting esophageal cancer if you smoke, drink heavily, or have acid reflux. Your risk also goes up as you age

Your doctor uses imaging tests and a biopsy to diagnose esophageal cancer. Treatments include surgery, radiation, and chemotherapy. You might also need nutritional support, since the cancer or treatment may make it hard to swallow.

NIH: National Cancer Institute


[Learn More in MedlinePlus]

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]

Stomach Cancer

The stomach is an organ between the esophagus and the small intestine. It mixes food with stomach acid and helps digest protein. Stomach cancer mostly affects older people - two-thirds of people who have it are over age 65. Your risk of getting it is also higher if you:

  • Have had a Helicobacter pylori infection
  • Have had stomach inflammation
  • Are a man
  • Eat lots of salted, smoked, or pickled foods
  • Smoke cigarettes
  • Have a family history of stomach cancer

It is hard to diagnose stomach cancer in its early stages. Indigestion and stomach discomfort can be symptoms of early cancer, but other problems can cause the same symptoms. In advanced cases, there may be blood in your stool, vomiting, unexplained weight loss, jaundice, or trouble swallowing. Doctors diagnose stomach cancer with a physical exam, blood and imaging tests, an endoscopy, and a biopsy.

Because it is often found late, it can be hard to treat stomach cancer. Treatment options include surgery, chemotherapy, radiation or a combination.

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