Z86.0100 — Personal history of colon polyps, unspecified
Is Z86.0100 billable?
Yes, but Z86.0100 is an unspecified code. Z86.0100 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, Z86.0100 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting Z86.0100 — the more specific alternatives are listed below.
Z86.0100 at a glance
| Code | Z86.0100 |
|---|---|
| Description | Personal history of colon polyps, unspecified |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to Z86.0100?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z86.0100 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 Z86.0100 group to?
Z86.0100 sits in MDC 23 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 951Other Factors Influencing Health Statusmedical
How is Z86.0100 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to Z86.0100. They show the wording a clinician may have documented, which often differs from the Tabular description.
- History › personal › neoplasm › benign › colon polyp
Inclusion terms
Alternative wording in documentation that is classified to Z86.0100.
- Personal history of colon polyps NOS
Code first — inherited from Z86
The underlying condition below must be sequenced before Z86.0100. Z86.0100 describes a manifestation and cannot be the principal or first-listed diagnosis.
- any follow-up examination after treatment (Z09)
Excludes2 — not included here — inherited from Z86.0
The conditions below are not part of Z86.0100, but a patient may have both at the same time. When documentation supports it, Z86.0100 and the excluded code may both be reported.
- personal history of malignant neoplasms (Z85.-)
Code also — inherited from Z77-Z99
Two codes may be needed to describe the condition fully. Whether Z86.0100 is sequenced first depends on the reason for the encounter.
- any follow-up examination (Z08-Z09)
How long has Z86.0100 existed?
Z86.0100 first appears in FY2025.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.