2026 ICD-10-CM Diagnosis Code Z86.000Personal history of in-situ neoplasm of breast

ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z86

ICD-10-CM Z86.000
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z86.000 is a billable ICD-10-CM diagnosis code for personal history of in-situ neoplasm of breast. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). 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 carcinoma in situ of breast. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Personal history of other disease.

Code Identity

ICD-10-CM Code
Z86.000
Billable Status
Yes — Valid for Submission
Code Describes
Personal history of in-situ neoplasm of breast
Short Description
Personal history of in-situ neoplasm of breast
Same as the full description in the CMS dataset.
Parent Code
Z86.00
Personal history of in-situ 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
CategoryZ86Personal history of certain other diseases
This CodeZ86.000Personal history of in-situ neoplasm of breast

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z86.000.

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

Z86.000 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 carcinoma in situ of breast
  • History of ductal carcinoma in situ of bilateral breasts
  • History of ductal carcinoma in situ of breast
  • History of ductal carcinoma in situ of left breast
  • History of ductal carcinoma in situ of right breast
  • History of lobular carcinoma in situ

Tabular List NotesGuidance

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

Inclusion Terms

  • Conditions classifiable to D05

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)
        • in situ neoplasm
          • breast
    • History
      • personal (of)
        • neoplasm
          • in situ
            • breast

Clinical ClassificationClinical

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

CCSR FAC030
Personal history of other disease
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 Z86.000 to ICD-9-CMHistory

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

ICD-9-CM
V13.89 Hx diseases NEC
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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z86.000Overview

Is Z86.000 (Personal history of in-situ neoplasm) a billable code?

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

Can Z86.000 be a principal diagnosis?

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

Is Z86.000 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 in-situ neoplasm of breast on inpatient claims.

What is the ICD-9 equivalent of Z86.000?

Under the General Equivalence Mappings, personal history of in-situ neoplasm of breast converts to ICD-9-CM V13.89 (hx diseases NEC). The mapping is approximate, so confirm the match fits the documentation.