Family History Breast Cancer ICD-10-CM Codes | 2023

What ICD-10 Codes are Used for Family History Breast Cancer 

When documenting a family history of breast cancer, healthcare providers rely on specific ICD-10 codes to ensure accurate and standardized record-keeping. Below are 6 to 10 commonly used codes for family history of breast cancer, along with their clinical descriptions:

Z80.3 - Family history of malignant neoplasm of the breast

This code indicates a family history of breast cancer, where the patient does not have a current diagnosis. It signifies the presence of breast cancer in one or more family members but not necessarily in the patient themselves.

Z15.02 - Genetic susceptibility to malignant neoplasm of the breast

This code is assigned when there is a documented genetic susceptibility to breast cancer, such as a positive BRCA1 or BRCA2 gene mutation.

Z80.41 - Family history of malignant neoplasm of the ovary

Although not specific to breast cancer, this code is important to document as ovarian and breast cancers are often genetically linked.

Z85.3 - Personal history of malignant neoplasm of the breast

This code is used when a patient has a personal history of breast cancer, indicating that they have previously been diagnosed.

Z86.010 - Personal history of bilateral prophylactic mastectomy

This code is used when a patient has undergone a bilateral prophylactic mastectomy as a risk-reducing measure due to a family history of breast cancer.

Z87.89 - Personal history of other specified conditions

This code documents any other relevant personal history conditions that may contribute to the risk of developing breast cancer, such as hormone replacement therapy or radiation exposure.

Z31.5 - Encounter for genetic testing for other genetic diseases

This code is used when the purpose of the encounter is for genetic testing related to breast cancer susceptibility.

Z15.01 - Genetic susceptibility to malignant neoplasm of the ovary

Similar to Z15.02, this code is assigned when there is a documented genetic susceptibility to ovarian cancer.

Which Family History Breast Cancer ICD codes are Billable?

Z80.3 - Yes, this code is billable as it represents a documented family history of breast cancer.

Z15.02 - Yes, this code is billable when there is a confirmed genetic susceptibility to breast cancer.

Z80.41 - Yes, this code is billable as it indicates a family history of malignant neoplasm of the ovary.

Z85.3 - Yes, this code is billable when a patient has a personal history of breast cancer.

Z86.010 - Yes, this code is billable when a patient has undergone bilateral prophylactic mastectomy.

Z87.89 - No, this code is not specifically billable for a family history of breast cancer but can be used to document other relevant personal history conditions.

Z31.5 - No, this code is not billable specifically for a family history of breast cancer but for genetic testing for other genetic diseases.

Z15.01 - No, this code is not specifically billable for a family history of breast cancer but for genetic susceptibility to malignant neoplasm of the ovary.

Clinical Information

• Family history breast cancer ICD-10-CM codes provide essential clinical information regarding a patient's risk for developing breast cancer based on their familial background.
• The code Z80.3 signifies a documented family history of breast cancer, indicating a potential increased risk for the patient and highlighting the importance of regular screenings and early detection measures.
• Z15.01 represents a known genetic susceptibility to breast cancer, suggesting the presence of specific genetic mutations like BRCA1 or BRCA2, which can impact management decisions and preventive strategies.
• While Z80.41 and Z80.42 codes indicate family histories of ovarian and prostate cancers, respectively, they can be relevant in assessing shared genetic risk factors associated with breast cancer.
• Z80.49, Z80.8, and Z80.9 encompass family histories of malignant neoplasms in other organs or systems, providing a broader context for evaluating overall cancer risk and guiding comprehensive care.
• These codes assist healthcare professionals in identifying patients who may require additional surveillance, genetic testing, or specialized interventions to mitigate their risk of developing breast cancer.
• Clinical information from family history codes enables personalized risk assessment, facilitating informed decision-making and tailored management plans for patients with a familial predisposition to breast cancer.

Synonyms Include:

• Family history of breast carcinoma
• FH: Breast cancer
• Genetic Predisposition to breast cancer
• Inherited breast cancer
• BRCA1/BRCA2 mutation carrier