Z86.12 — Personal history of poliomyelitis

Billable

Is Z86.12 billable?

Yes — Z86.12 is billable for FY2027. Z86.12 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z86.12 may be submitted for encounters from October 1, 2026 through September 30, 2027.

Z86.12 at a glance

Code	Z86.12
Description	Personal history of poliomyelitis
Billable	Yes
Code set	ICD-10-CM FY2027
Valid for encounters	October 1, 2026 – September 30, 2027

What Medicare edits apply to Z86.12?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z86.12 directly.

Cannot be a principal diagnosis — MCE edit 9

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 Z86.12 group to?

Z86.12 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 Z86.12 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to Z86.12. They show the wording a clinician may have documented, which often differs from the Tabular description.

History › personal › disease or disorder › infectious › poliomyelitis

Excludes1 — never code together — inherited from Z86.1

The conditions below can never be reported together with Z86.12 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

personal history of infectious diseases specific to a body system
sequelae of infectious and parasitic diseases (B90-B94)

Code first — inherited from Z86

The underlying condition below must be sequenced before Z86.12. Z86.12 describes a manifestation and cannot be the principal or first-listed diagnosis.

any follow-up examination after treatment (Z09)

Code also — inherited from Z77-Z99

Two codes may be needed to describe the condition fully. Whether Z86.12 is sequenced first depends on the reason for the encounter.

any follow-up examination (Z08-Z09)

How long has Z86.12 existed?

Z86.12 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.