ICD-10-CM Code Z86.011

Personal history of benign neoplasm of the brain

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z86.011 is a billable code used to specify a medical diagnosis of personal history of benign neoplasm of the brain. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z86.011 might also be used to specify conditions or terms like history of benign meningioma of brain, history of benign neoplasm of brain, history of cerebellar meningioma, history of cerebral meningioma, history of neoplasm of pituitary gland, history of pituitary adenoma, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z86.011 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.

ICD-10:Z86.011
Short Description:Personal history of benign neoplasm of the brain
Long Description:Personal history of benign neoplasm of the brain

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z86.011 are found in the index:


Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 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.

Synonyms

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

  • History of benign meningioma of brain
  • History of benign neoplasm of brain
  • History of cerebellar meningioma
  • History of cerebral meningioma
  • History of neoplasm of pituitary gland
  • History of pituitary adenoma
  • History of prolactinoma

Present on Admission (POA)

Z86.011 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 Indicator CodePOA Reason 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 Z86.011 to ICD-9

  • V12.41 - Hx benign neoplasm brain

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)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Benign Tumors

Tumors are abnormal growths in your body. They can be either benign or malignant. Benign tumors aren't cancer. Malignant ones are. Benign tumors grow only in one place. They cannot spread or invade other parts of your body. Even so, they can be dangerous if they press on vital organs, such as your brain.

Tumors are made up of extra cells. Normally, cells grow and divide to form new cells as your body needs them. When cells grow old, they die, and new cells take their place. Sometimes, this process goes wrong. New cells form when your body does not need them, and old cells do not die when they should. These extra cells can divide without stopping and may form tumor.

Treatment often involves surgery. Benign tumors usually don't grow back.

NIH: National Cancer Institute


[Learn More]

Brain Tumors

A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, or malignant, with cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are metastatic, and they start somewhere else in the body and move to the brain.

Brain tumors can cause many symptoms. Some of the most common are

  • Headaches, often in the morning
  • Nausea and vomiting
  • Changes in your ability to talk, hear, or see
  • Problems with balance or walking
  • Problems with thinking or memory
  • Feeling weak or sleepy
  • Changes in your mood or behavior
  • Seizures

Doctors diagnose brain tumors by doing a neurologic exam and tests including an MRI, CT scan, and biopsy. Treatment options include watchful waiting, surgery, radiation therapy, chemotherapy, and targeted therapy. Targeted therapy uses substances that attack cancer cells without harming normal cells. Many people get a combination of treatments.

NIH: National Cancer Institute


[Learn More]