Is ICD-10-CM code Z80 billable?

No, Z80 (Family history of primary malignant neoplasm) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code Z80 belong to?

Z80 belongs to Chapter 21 of the ICD-10-CM tabular list: Z00–Z99 (Factors Influencing Health Status and Contact with Health Services).

Z80Not billable, use a more specific code below

Family history of primary malignant neoplasm

In Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99), chapter 21: Factors Influencing Health Status and Contact with Health Services

16 billable codes under Z80: none are a CC or MCC; none map to an HCC.

Instructional notes

Also applies, from Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)

These notes sit on Z77-Z99 and apply to every code under it, including Z80.

Code also: add a code for this too, order depends on the encounter

any follow-up examination (Z08-Z09)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers when and how to use Z codes (Z00-Z99) for encounters and supplementary information, including contact, status, history, screening, aftercare, exams, and social determinants of health.

Use of Z Codes in Any Healthcare Setting (page 92)
Z Codes Indicate a Reason for an Encounter or Provide Additional Information about a Patient Encounter (page 93)
Categories of Z Codes (page 93)

Read Section I.C.21 (page 92)

All codes under Z80

Z80 can't be used on a claim. Pick a billable code below; grey headings group them.

Z80 MS-DRG

As the principal diagnosis, all 16 billable codes under Z80 group to MS-DRG 951 (v44.0).

DRG 951 Other Factors Influencing Health Status

Other codes that refer to Z80

Notes on these codes point to Z80.

Z12 Use Additional Code: code to identify any family history of malignant neoplasm (Z80.-)
Z15 Use Additional Code: code, if applicable, for any associated family history of the disease (Z80-Z84)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

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. These extra cells can form a mass called a tumor.

Family History

Your family history includes health information about you and your close relatives. Families have many factors in common, including their genes, environment, and lifestyle. Looking at these factors can help you figure out whether you have a higher risk for certain health problems, such as heart disease, stroke, and cancer.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.