Z85.818 — Personal history of malignant neoplasm of other sites of lip, oral cavity, and pharynx
Is Z85.818 billable?
Yes — Z85.818 is billable for FY2027. Z85.818 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z85.818 may be submitted for encounters from October 1, 2026 through September 30, 2027.
Z85.818 at a glance
| Code | Z85.818 |
|---|---|
| Description | Personal history of malignant neoplasm of other sites of lip, oral cavity, and pharynx |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to Z85.818?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z85.818 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 Z85.818 group to?
Z85.818 sits in MDC Pre 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.
- 011Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCCsurgical
- 012Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CCsurgical
- 013Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCCsurgical
How is Z85.818 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to Z85.818. They show the wording a clinician may have documented, which often differs from the Tabular description.
- History › personal › malignant neoplasm › oral cavity › specified site NEC
- History › personal › malignant neoplasm › pharynx › specified site NEC
Code first — inherited from Z85
The underlying condition below must be sequenced before Z85.818. Z85.818 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 Z85.818 to fully describe the condition. Z85.818 is sequenced first.
Excludes2 — not included here — inherited from Z85
The conditions below are not part of Z85.818, but a patient may have both at the same time. When documentation supports it, Z85.818 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 Z85.818 is sequenced first depends on the reason for the encounter.
- any follow-up examination (Z08-Z09)
How long has Z85.818 existed?
Z85.818 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.