2025 ICD-10-CM Diagnosis Code Z85.43
Personal history of malignant neoplasm of ovary
- ICD-10-CM Code:
- Z85.43
- ICD-10 Code for:
- Personal history of malignant neoplasm of ovary
- Is Billable?
- Yes - Valid for Submission
- Code Navigator:
Z85.43 is a billable diagnosis code used to specify a medical diagnosis of personal history of malignant neoplasm of ovary. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2024 through September 30, 2025. 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.
Approximate Synonyms
The following list of clinical terms are approximate synonyms, alternative descriptions, or common phrases that might be used by patients, healthcare providers, or medical coders to describe the same condition. These synonyms and related diagnosis terms are often used when searching for an ICD-10 code, especially when the exact medical terminology is unclear. Whether you're looking for lay terms, similar diagnosis names, or common language alternatives, this list can help guide you to the correct ICD-10 classification.
- History of bilateral primary malignant neoplasm of ovaries
- History of carcinosarcoma of ovary
- History of germ cell tumor
- History of malignant germ cell neoplasm of ovary
- History of malignant neoplasm of female genital organ
- History of malignant neoplasm of female genital organ
- History of malignant neoplasm of female genital organ
- History of malignant neoplasm of ovary
- History of malignant neoplasm of uterine adnexa
- History of malignant neoplasm of uterine adnexa
- History of malignant neoplasm of uterine adnexa
- History of malignant neoplasm of uterine adnexa
- History of malignant neoplasm of uterine adnexa
- History of malignant neoplasm of uterine adnexa
- History of neoplasm of low malignant potential behavior of ovary
- History of primary malignant neoplasm of left ovary
- History of primary malignant neoplasm of right ovary
- History of sex cord stromal tumor of ovary
Clinical Classification
Clinical Classifications group individual ICD-10-CM diagnosis codes into broader, clinically meaningful categories. These categories help simplify complex data by organizing related conditions under common clinical themes.
They are especially useful for data analysis, reporting, and clinical decision-making. Even when diagnosis codes differ, similar conditions can be grouped together based on their clinical relevance. Each category is assigned a unique CCSR code that represents a specific clinical concept, often tied to a body system or medical specialty.
Personal/family history of disease
CCSR Code: FAC021
Inpatient Default: X - Not applicable.
Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
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).
- - History
- - personal (of) - See Also: History, family (of);
- - malignant neoplasm (of) - Z85.9
- - ovary - Z85.43
- - malignant neoplasm (of) - Z85.9
- - personal (of) - See Also: History, family (of);
Code Edits
The Medicare Code Editor (MCE) detects errors and inconsistencies in ICD-10-CM diagnosis coding that can affect Medicare claim validity. These Medicare code edits help medical coders and billing professionals determine when a diagnosis code is not appropriate as a principal diagnosis, does not meet coverage criteria. Use this list to verify whether a code is valid for Medicare billing and to avoid claim rejections or denials due to diagnosis coding issues.
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)
Z85.43 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: Y
Reason: Diagnosis was present at time of inpatient admission.
CMS Pays CC/MCC DRG? YES
POA Indicator: N
Reason: Diagnosis was not present at time of inpatient admission.
CMS Pays CC/MCC DRG? NO
POA Indicator: U
Reason: Documentation insufficient to determine if the condition was present at the time of inpatient admission.
CMS Pays CC/MCC DRG? NO
POA Indicator: W
Reason: Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.
CMS Pays CC/MCC DRG? YES
POA Indicator: 1
Reason: Unreported/Not used - Exempt from POA reporting.
CMS Pays CC/MCC DRG? NO
Convert Z85.43 to ICD-9-CM
Below are the ICD-9 codes that most closely match this ICD-10 code, based on the General Equivalence Mappings (GEMs). This ICD-10 to ICD-9 crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.
Hx of ovarian malignancy
ICD-9-CM: V10.43
This is a direct match with no additional mapping qualifiers. The absence of a flag generally means the mapping is considered exact or precise. In other words, the ICD-10 code maps cleanly to the ICD-9 code without qualification, approximation, or needing multiple codes.
Patient Education
Ovarian Cancer
What is ovarian cancer?
Cancer is a disease in which abnormal cells in the body grow out of control and form a tumor. Ovarian cancer is a cancerous tumor that forms in the tissues of an ovary. The ovaries are a pair of female reproductive glands that make eggs and female hormones.
What are the types of ovarian cancer?
There are a few different types of ovarian cancer. The most common type is epithelial cancer. It begins in the cells that cover the ovary.
There are also two related types of epithelial cancer that can spread to the ovaries:
- Fallopian tube cancer forms in the tissue lining a fallopian tube. The fallopian tubes are a pair of long, slender tubes on each side of the uterus. The uterus is the female reproductive organ where a baby grows during pregnancy.
- Primary peritoneal cancer forms in the tissue lining the peritoneum. Your peritoneum is a tissue lining that covers the organs in the abdomen (belly).
These two cancers are similar to ovarian cancer, and they have the same treatments. So some medical experts also consider those two types as ovarian cancer.
Some other rarer types of ovarian cancer are malignant germ cell tumors and stromal tumors.
What causes ovarian cancer?
Ovarian cancer happens when there are changes (mutations) in the genetic material (DNA). Often, the exact cause of these genetic changes is unknown.
Most ovarian cancers are caused by genetic changes that happen during your lifetime. But sometimes these genetic changes are inherited, meaning that you are born with them. Ovarian cancer that is caused by inherited genetic changes is called hereditary ovarian cancer.
There are also certain genetic changes that can raise your risk of ovarian cancer, including changes called BRCA1 and BRCA2. These two changes also raise your risk of breast and other cancers.
Besides genetics, your lifestyle and the environment can affect your risk of ovarian cancer.
Who is more likely to develop ovarian cancer?
Certain people are more likely to develop ovarian cancer. They include those who:
- Have a family history of ovarian cancer in a mother, daughter, or sister
- Have inherited changes in the BRCA1 or BRCA2 genes.
- Have certain other genetic conditions, such as Lynch syndrome
- Have endometriosis
- Took hormone replacement therapy
- Are overweight or have obesity
- Are tall
- Are older, especially those who have gone through menopause
What are the symptoms of ovarian cancer?
Ovarian cancer may not cause early signs or symptoms. By the time you do have signs or symptoms, the cancer is often advanced.
The signs and symptoms may include:
- Pain, swelling, or a feeling of pressure in the abdomen or pelvis
- Sudden or frequent urge to urinate (pee)
- Trouble eating or feeling full
- A lump in the pelvic area
- Gastrointestinal problems, such as gas, bloating, or constipation
How is ovarian cancer diagnosed?
To find out if you have ovarian cancer, your health care provider:
- Will ask about your medical history, including your symptoms
- Will ask about your family health history, including relatives who have had ovarian cancer
- Will do a physical exam, including a pelvic exam
- Will likely do imaging tests
- May do blood tests such as a CA-125 blood test
Often the only way to know for sure that you have ovarian cancer is by having a biopsy of the tissue. A biopsy is done during surgery to remove the tumor.
What are the treatments for ovarian cancer?
Treatments for ovarian cancer may include:
- Surgery to remove as much of the cancer as possible
- Chemotherapy
- Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells
Your provider may suggest that you have genetic testing to look for the gene changes that raise the risk for ovarian cancer. Knowing whether or not you have the gene change may help your provider decide on your treatment plan.
NIH: National Cancer Institute
[Learn More in MedlinePlus]
Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®)
Learn about ovarian epithelial, fallopian tube, and primary peritoneal cancer risk factors, symptoms, tests to diagnose, factors affecting prognosis, staging, and treatment.[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
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.