2026 ICD-10-CM Diagnosis Code Z86.004Personal history of in-situ neoplasm of other and unspecified digestive organs

ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z86

ICD-10-CM Z86.004
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z86.004 is a billable ICD-10-CM diagnosis code for personal history of in-situ neoplasm of other and unspecified digestive organs. 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Personal history of other disease.

Code Identity

ICD-10-CM Code
Z86.004
Billable Status
Yes — Valid for Submission
Code Describes
Personal history of in-situ neoplasm of other and unspecified digestive organs
Short Description
Pers hx of in-situ neoplasm of other and unsp dgstv orgs
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 CodeZ86.004Personal history of in-situ neoplasm of other and unspecified digestive organs

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z86.004.

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

Z86.004 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Tabular List NotesGuidance

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

Inclusion Terms

  • Conditions classifiable to D01
  • Personal history of anal intraepithelial neoplasia (AIN III)

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
          • digestive organs, specified NEC
    • History
      • personal (of)
        • neoplasia
          • anal intraepithelial, III [AIN III]
    • History
      • personal (of)
        • neoplasm
          • in situ
            • digestive organs, specified NEC

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

Cancer

Cancer is not just one disease but many diseases. Cancer begins in your cells, which are the building blocks of your body. Usually, your body forms new cells as needed, replacing old cells that die. Sometimes this process goes wrong. New cells grow even when you don't need them, and old cells don't die when they should.

The full article covers:

  • What is cancer?
  • What are the types of cancer?
  • How does cancer develop?
  • What are the symptoms of cancer?
  • How is cancer diagnosed?
  • What are the treatments for cancer?
  • Can cancer be prevented?

Read the full article at MedlinePlus

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

Code History & ChangesHistory

Replacement Z86.004 replaces the following previously assigned code(s):

  • Z86.008 - Personal history of in-situ neoplasm of other site
FY 2020AddedAdded to the ICD-10-CM code setEffective October 1, 2019.
FY 2021–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z86.004Overview

Is Z86.004 (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 other and unspecified digestive organs on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Can Z86.004 be a principal diagnosis?

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

Is Z86.004 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 other and unspecified digestive organs on inpatient claims.