Z86.0109 — Personal history of other colon polyps
Is Z86.0109 billable?
Yes — Z86.0109 is billable for FY2027. Z86.0109 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z86.0109 may be submitted for encounters from October 1, 2026 through September 30, 2027.
Z86.0109 at a glance
| Code | Z86.0109 |
|---|---|
| Description | Personal history of other colon polyps |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to Z86.0109?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z86.0109 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 Z86.0109 group to?
Z86.0109 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 Z86.0109 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to Z86.0109. They show the wording a clinician may have documented, which often differs from the Tabular description.
- History › personal › neoplasm › benign › colon polyp › specified NEC
Code first — inherited from Z86
The underlying condition below must be sequenced before Z86.0109. Z86.0109 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 Z86.0109, but a patient may have both at the same time. When documentation supports it, Z86.0109 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 Z86.0109 is sequenced first depends on the reason for the encounter.
- any follow-up examination (Z08-Z09)
How long has Z86.0109 existed?
Z86.0109 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.