2025 ICD-10-CM code Z80.0
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Factors influencing health status and contact with health services - Persons with potential health hazards related to family and personal history and certain conditions influencing health status Chapter 21: Factors influencing health status and contact with health services Feed
Family history of malignant neoplasm of digestive organs. This code is used for encounters for screening or other preventative services.
Modifiers are not applicable to ICD-10 codes.
Medical necessity is established by the patient's family history of digestive cancers increasing their risk of developing similar cancers.The preventative services provided are considered medically necessary to reduce that risk.
The clinical responsibility is to assess the patient's risk based on their family history and to provide appropriate screening and preventative care.
- Chapter 21: Factors influencing health status and contact with health services
- Z77-Z99: Persons with potential health hazards related to family and personal history and certain conditions influencing health status
In simple words: This code means the patient has a family history of cancer in their digestive system (like the stomach, intestines, liver, etc.). The doctor might use this code if the patient is getting a checkup or test because of their family's history, not because they currently have cancer.
This ICD-10-CM code, Z80.0, signifies a family history of malignant neoplasms (cancers) affecting the digestive organs.It's used when a patient presents for screening, preventative care, or other services related to their family history of digestive cancers.This code does not indicate an active cancer diagnosis in the patient themselves, only a relevant family history.The code is often used in conjunction with procedure codes when a preventative procedure is performed, such as a colonoscopy.It's crucial to note that a separate diagnostic code is necessary if the patient presents with symptoms or findings suggestive of active disease.Use of this code is exempt from Present on Admission (POA) reporting requirements.
Example 1: A 50-year-old patient with a strong family history of colon cancer (mother and aunt diagnosed with colorectal cancer before age 60) presents for a screening colonoscopy.Code Z80.0 is used in conjunction with the appropriate colonoscopy procedure code., A 45-year-old patient whose father died from pancreatic cancer at age 55 requests genetic counseling and risk assessment. Code Z80.0 would be used to document the family history, even without a specific procedure., A 62-year-old patient with a family history of gastric cancer undergoes an upper endoscopy as a screening procedure.Code Z80.0 is utilized along with the appropriate procedural code.
Detailed family history of digestive cancers, including type of cancer, age of diagnosis, and relationship to the patient.Documentation of the reason for the encounter (e.g., screening, risk assessment, genetic counseling) and any procedures performed.
** This code is solely for family history and does not represent an active diagnosis.Always ensure proper documentation supports code selection. The code is exempt from POA reporting.
- Revenue Code: Revenue codes will vary depending on the specific service provided and payer.
- RVU: RVUs are not applicable to ICD-10 codes.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.
- Specialties:Gastroenterology, Oncology, Genetics, Family Medicine
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center