2027 ICD-10-CM Diagnosis Code Z98.86Personal history of breast implant removal
Z98.86 is a billable ICD-10-CM diagnosis code for personal history of breast implant removal. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. 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 bilateral removal of breast implants. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Personal history of other disease.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z98.86.
Present on Admission (POA)Billing
Z98.86 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- History of bilateral removal of breast implants
- History of removal of breast implant
- History of removal of left breast implant
- History of removal of right breast implant
- Removal of implant since previous mammogram
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z98.86: its own notes plus those printed at Z98, block Z77-Z99, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Notes
General instructions on how these codes are used.
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Z98.86, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming Z98.86: they are not reported together with it, unless the two conditions are unrelated.
- Z98.82 Breast implant statusbreast implant removal status (Z98.86)
Excludes2 2
These codes carry an Excludes2 note naming Z98.86: its condition is not part of those codes, and both may be reported when the patient has both.
Use Additional Code 1
These codes say to use an additional code from the note, and Z98.86 is one of the codes named.
- C84.7A Anaplastic large cell lymphoma, ALK-negative, breastpersonal history of breast implant removal (Z98.86)
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
personal (of) See Also: History, family (of);
breast implant removal Z98.86
Status (post) See Also: Presence (of);
removal Z98.86
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Convert Z98.86 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z98.86Overview
What is the ICD-10 code for personal history of breast implant removal?
The ICD-10-CM code for personal history of breast implant removal is Z98.86 (sometimes written as Z9886). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z98.86 (Other specified postprocedural states) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report personal history of breast implant removal on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z98.86 group to?
On inpatient claims, personal history of breast implant removal maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.
Can Z98.86 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because personal history of breast implant removal describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z98.86 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 breast implant removal on inpatient claims. The code appears in the Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99) range of the CMS exempt list.
