Z85.59: Personal history of malignant neoplasm of other urinary tract organ

Z85.59, personal history of malignant neoplasm of other urinary tract organ, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 15 HCPCS Level II codes, including J9267 (Injection, paclitaxel, 1 mg), J9264 (Injection, paclitaxel protein-bound particles, 1 mg), J0461 (Injection, atropine sulfate, 0.01 mg). The articles come from 3 Medicare contractors. 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 Z85.59 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J9267Injection, paclitaxel, 1 mgSpecial coverage instructions apply—1
J9264Injection, paclitaxel protein-bound particles, 1 mgCarrier judgment—1
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—1
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—1
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—1
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—1
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—1
J8999Prescription drug, oral, chemotherapeutic, nosSpecial coverage instructions apply—1
Q0512Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day periodSpecial coverage instructions apply—1
Q0511Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day periodSpecial coverage instructions apply—1
J8530Cyclophosphamide; oral, 25 mgSpecial coverage instructions apply—1
J8597Antiemetic drug, oral, not otherwise specifiedSpecial coverage instructions apply—1
J8610Methotrexate; oral, 2.5 mgSpecial coverage instructions apply—1
J8498Antiemetic drug, rectal/suppository, not otherwise specifiedSpecial coverage instructions apply—1
A9270Non-covered item or serviceNon-covered by MedicareNot covered1

Medicare policy articles listing Z85.59

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.

Other Z85 diagnoses (Personal history of malignant neoplasm)

Frequently asked questions

Does Medicare cover Z85.59 (Personal history of malignant neoplasm of other urinary…)?

Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list Z85.59 as a covered diagnosis for 15 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 Z85.59?

The Level II codes from the policies most specific to this diagnosis are J9267 (Injection, paclitaxel, 1 mg, 1 article); J9264 (Injection, paclitaxel protein-bound particles, 1 mg, 1 article); J0461 (Injection, atropine sulfate, 0.01 mg, 1 article); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 1 article); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list Z85.59?

A52450 (Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)); A54768 (Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy); A52479 (Oral Anticancer Drugs - Policy Article).

What is ICD-10-CM code Z85.59?

Z85.59 is the ICD-10-CM code for personal history of malignant neoplasm of other urinary tract organ, in category Z85 (Personal history of malignant neoplasm), chapter 22: Factors influencing health status and contact with health services.

Next steps

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