2025 ICD-10-CM code Z86.1
(Active) Effective 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 (Z77-Z99) Chapter 21: Factors influencing health status and contact with health services (Z00-Z99) Feed
Personal history of infectious and parasitic diseases (Conditions classifiable to A00-B99).
No modifiers are applicable to Z codes.
The code Z86.1 itself does not indicate medical necessity for any specific service.It provides context for the patient's current condition and may influence medical decision-making.A related diagnosis or procedure code will typically justify the medical necessity of the encounter.
The provider is responsible for accurately documenting the patient's past medical history, including any previous infectious or parasitic diseases. This information should be used to guide current and future care decisions.
- Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)
- Z86 - Personal history of certain other diseases
In simple words: This code indicates that the patient has had an infectious or parasitic disease in the past.
This code indicates a past history of an infectious or parasitic disease classifiable to A00-B99. It is used to document the past medical history of a patient and may be relevant for current health status or future treatment decisions.
Example 1: A patient presents for an annual physical and reports a history of malaria. The provider documents this history using code Z86.1., A patient with a history of tuberculosis is admitted to the hospital for an unrelated condition. The provider documents the tuberculosis history using code Z86.1., A patient presents to their physician with symptoms suggestive of a recurrent parasitic infection. The physician reviews the patient's history and notes a previous diagnosis of the same parasitic infection, documented with code Z86.1.
Documentation should include the specific infectious or parasitic disease(s) the patient has had in the past. Any related complications or sequelae should also be documented.
** Code also any follow-up examination (Z08-Z09). Code first any follow-up examination after treatment (Z09). Excludes1: personal history of infectious diseases specific to a body system and sequelae of infectious and parasitic diseases (B90-B94).
- Payment Status: Active
- Modifier TC rule: No TC modifier applies to Z codes.
- Specialties:Any specialty may utilize this code when appropriate.
- Place of Service:Any place of service may be appropriate.