Z85.46 — Personal history of malignant neoplasm of prostate
Is Z85.46 billable?
Yes — Z85.46 is billable for FY2027. Z85.46 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z85.46 may be submitted for encounters from October 1, 2026 through September 30, 2027.
Z85.46 at a glance
| Code | Z85.46 |
|---|---|
| Description | Personal history of malignant neoplasm of prostate |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to Z85.46?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z85.46 directly.
CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.
Which MS-DRGs does Z85.46 group to?
Z85.46 sits in MDC 17 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 826Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with MCCsurgical
- 827Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with CCsurgical
- 828Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures without CC/MCCsurgical
How is Z85.46 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to Z85.46. They show the wording a clinician may have documented, which often differs from the Tabular description.
- History › personal › malignant neoplasm › prostate
Code first — inherited from Z85
The underlying condition below must be sequenced before Z85.46. Z85.46 describes a manifestation and cannot be the principal or first-listed diagnosis.
- any follow-up examination after treatment of malignant neoplasm (Z08)
Use additional code — inherited from Z85
Report an additional code alongside Z85.46 to fully describe the condition. Z85.46 is sequenced first.
Excludes2 — not included here — inherited from Z85
The conditions below are not part of Z85.46, but a patient may have both at the same time. When documentation supports it, Z85.46 and the excluded code may both be reported.
Code also — inherited from Z77-Z99
Two codes may be needed to describe the condition fully. Whether Z85.46 is sequenced first depends on the reason for the encounter.
- any follow-up examination (Z08-Z09)
How long has Z85.46 existed?
Z85.46 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
What other codes are in the Z85.4 family? (10)
- Z85.40Personal history of malignant neoplasm of unspecified female genital organ
- Z85.41Personal history of malignant neoplasm of cervix uteri
- Z85.42Personal history of malignant neoplasm of other parts of uterus
- Z85.43Personal history of malignant neoplasm of ovary
- Z85.44Personal history of malignant neoplasm of other female genital organs
- Z85.45Personal history of malignant neoplasm of unspecified male genital organ
- Z85.47Personal history of malignant neoplasm of testis
- Z85.48Personal history of malignant neoplasm of epididymis
- Z85.49Personal history of malignant neoplasm of other male genital organs
- Z85.4APersonal history of malignant neoplasm of fallopian tube(s)