Z80.0: Family history of malignant neoplasm of digestive organs
Z80.0, family history of malignant neoplasm of digestive organs, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 5 HCPCS Level II codes, including G0105 (Colorectal cancer screening; colonoscopy on individual at…), G0121 (Colorectal cancer screening; colonoscopy on individual not…), G2204 (Patients between 45 and 85 years of age who received a…). The articles come from 1 Medicare contractor. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with Z80.0 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | Special coverage instructions apply | — | 3 |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | Special coverage instructions apply | — | 1 |
| G2204 | Patients between 45 and 85 years of age who received a screening colonoscopy during the performance period | Carrier judgment | — | 1 |
| G9998 | Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lower gastrointestinal bleeding, or patient at high risk for colon cancer due to underlying medical history ([i.e. crohn's disease, ulcerative colitis, personal or family history of colon cancer, hereditary colorectal cancer syndromes]) | Carrier judgment | — | 1 |
| G9999 | Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete) | Carrier judgment | — | 1 |
Medicare policy articles listing Z80.0
- A55069: Billing and Coding: Screening Colonoscopy Converted to a Diagnostic and/or Therapeutic Colonoscopy (Palmetto GBA (MAC - Part A, MAC - Part B); 2 Level II codes)
- A55227: Billing and Coding: Incomplete Colonoscopy/Failed Colonoscopy (Palmetto GBA (MAC - Part A, MAC - Part B); 2 Level II codes)
- A56632: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy (Palmetto GBA (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L34005, L34454
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Frequently asked questions
Does Medicare cover Z80.0 (Family history of malignant neoplasm of digestive organs)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list Z80.0 as a covered diagnosis for 5 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 Z80.0?
The Level II codes from the policies most specific to this diagnosis are G0105 (Colorectal cancer screening; colonoscopy on individual at…, 3 articles); G0121 (Colorectal cancer screening; colonoscopy on individual not…, 1 article); G2204 (Patients between 45 and 85 years of age who received a…, 1 article); G9998 (Documentation of medical reason(s) for an interval of less…, 1 article); G9999 (Documentation of system reason(s) for an interval of less…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list Z80.0?
A55069 (Billing and Coding: Screening Colonoscopy Converted to a Diagnostic and/or Therapeutic Colonoscopy); A55227 (Billing and Coding: Incomplete Colonoscopy/Failed Colonoscopy); A56632 (Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy).
What is ICD-10-CM code Z80.0?
Z80.0 is the ICD-10-CM code for family history of malignant neoplasm of digestive organs, in category Z80 (Family history of primary malignant neoplasm), chapter 22: Factors influencing health status and contact with health services.
Next steps
- Run a reimbursement report for a device billed under G0105
- Watch G0105 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0105
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 22: Factors influencing health status and contact with health services · All diagnoses · HCPCS lookup