Icd 10 for history of prostate cancer

On October 1, 2016, new codes were implemented in the ICD-10-CM. This was the first update since the original ICD-10-CM version was published in 2015. Among this update is a change to help identify different manifestations for prostate cancer.

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Family history of malignant neoplasm, unspecified
Family history of malignant neoplasm of other genital organs
How do I code history of prostate cancer?
Can Z85 3 be used as a primary diagnosis code?
What is the ICD
What is the ICD

To identify prostate cancer, diagnosis code C61 Malignant neoplasm of prostate was established, as well as “ “use additional code to identify” guidance for hormone sensitivity status and for rising prostate-specific antigen (PSA) following prostate cancer treatment .

The ICD-10-CM manual lists the following:

C61 Malignant neoplasm of prostate

Use additional code to identify

Hormone sensitivity status (Z19.1-Z19.2)

Rising PSA following treatment for malignant neoplasm of prostate (R97.21)

The hormone sensitivity status codes include:

Z19.1 Hormone sensitive malignancy status

Z19.2 Hormone resistant malignancy status

When using diagnosis code C61, you can also add the additional codes for more specific identification. It should not be required to add the codes if they are not relevant. Some clearinghouses are requiring the use of the additional codes before claims are processed but this should not be the case.

The AUA has unlimited expert coding advice through the Coding Hotline which is part of the Practice Management Network. For more information on the Coding hotline and other Coding Products please click here.

ICD-10 ChapterCodesCode Description2C61Malignant neoplasm of prostate21Z12.5Encounter for screening for malignant neoplasm of prostate21Z80.42Family history of malignant neoplasm of prostate21Z85.46Personal history of malignant neoplasm of prostate

"Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered POA.

Z80.42 is considered exempt from POA reporting.

ICD-10-CM Z80.42 is grouped within Diagnostic Related Group(s) (MS-DRG v40.0):

951 Other factors influencing health status

Convert Z80.42 to ICD-9-CM

Code History

2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
2017 (effective 10/1/2016): No change
2018 (effective 10/1/2017): No change
2019 (effective 10/1/2018): No change
2020 (effective 10/1/2019): No change
2021 (effective 10/1/2020): No change
2022 (effective 10/1/2021): No change
2023 (effective 10/1/2022): No change

History
- family (of) - see also History, personal (of)
  - malignant neoplasm (of) Z80.9
    ICD-10-CM Diagnosis Code Z80.9
    Family history of malignant neoplasm, unspecified
    Applicable To
    - Conditions classifiable to C80.1
    - genital organ Z80.49
      ICD-10-CM Diagnosis Code Z80.49
      Family history of malignant neoplasm of other genital organs
    - prostate Z80.42

ICD-10-CM Codes Adjacent To Z80.42

Z79.891 Long term (current) use of opiate analgesic

Z79.899 Other long term (current) drug therapy

Z80 Family history of primary malignant neoplasm

Z80.0 Family history of malignant neoplasm of digestive organs

Z80.1 Family history of malignant neoplasm of trachea, bronchus and lung

Z80.2 Family history of malignant neoplasm of other respiratory and intrathoracic organs

Z80.3 Family history of malignant neoplasm of breast

Z80.4 Family history of malignant neoplasm of genital organs

Z80.41 Family history of malignant neoplasm of ovary

Z80.42 Family history of malignant neoplasm of prostate

Z80.43 Family history of malignant neoplasm of testis

Z80.49 Family history of malignant neoplasm of other genital organs

Z80.5 Family history of malignant neoplasm of urinary tract

Z80.51 Family history of malignant neoplasm of kidney

Z80.52 Family history of malignant neoplasm of bladder

Z80.59 Family history of malignant neoplasm of other urinary tract organ

Z80.6 Family history of leukemia

Z80.7 Family history of other malignant neoplasms of lymphoid, hematopoietic and related tissues

Z80.8 Family history of malignant neoplasm of other organs or systems

Z80.9 Family history of malignant neoplasm, unspecified

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

How do I code history of prostate cancer?

Personal history of malignant neoplasm of prostate Z85. 46 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2023 edition of ICD-10-CM Z85. 46 became effective on October 1, 2022.

Can Z85 3 be used as a primary diagnosis code?

Z85. 3 can be billed as a primary diagnosis if that is the reason for the visit, but follow up after completed treatment for cancer should coded as Z08 as the primary diagnosis.

What is the ICD

Breast Cancer ICD-10 Code Reference Sheet.

What is the ICD

ICD-10 code C34. 90 for Malignant neoplasm of unspecified part of unspecified bronchus or lung is a medical classification as listed by WHO under the range - Malignant neoplasms .