Z86.005: Pers hx of in-situ neoplasm of middle ear and resp sys
Personal history of in-situ neoplasm of middle ear and respiratory system
Quick Clinical & Billing Summary
What is ICD-10-CM code Z86.005? Z86.005 represents Pers hx of in-situ neoplasm of middle ear and resp sys. Under official CDC guidelines, this code is billable and specific for claim submission.
Code Hierarchy & Classification
Clinical Guidance & Documentation Standards
Associated Procedures & Medicare RVU Reimbursement
Open RVU Calculator →Typical outpatient and office evaluation procedures frequently billed alongside diagnosis Z86.005:
| CPT/HCPCS | Description | Work RVU | Non-Facility Fee | Facility Fee |
|---|---|---|---|---|
| 99213 | Office/outpatient visit, established patient, 20-29 minutes (Low MDM) | 1.30 | $91.69 | $66.79 |
| 99214 | Office/outpatient visit, established patient, 30-39 minutes (Moderate MDM) | 1.92 | $133.61 | $100.21 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection (subcutaneous/intramuscular) | 0.17 | $18.34 | $12.44 |
CPT Modifier & Billing Rules
Append when a significant, separately identifiable evaluation and management service is provided on the same calendar day as a minor surgical procedure or injection.
Identifies procedures or services not normally reported together but distinct under the clinical circumstances. Use CMS X-modifiers (XE, XS, XP, XU) where required by Medicare.
Frequently Asked Questions about Z86.005
Is Z86.005 a billable ICD-10 code?
Yes, Z86.005 is a valid, billable and specific ICD-10-CM code. It can be reported as a primary or secondary diagnosis on medical claims.
What is the ICD-10 code for Pers hx of in-situ neoplasm of middle ear and resp sys?
The primary ICD-10-CM code for Pers hx of in-situ neoplasm of middle ear and resp sys is Z86.005.
What is the effective date of the current Z86.005 code?
The code is active for fiscal year FY2027, effective starting 2026-10-01.
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