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C16.4 vs Z85.028

C16.4 (Malignant neoplasm of pylorus) compared with Z85.028 (Personal history of other malignant neoplasm of stomach), from the official CMS tabular data. Z85.028 is the personal-history/screening code for the active disease C16.4 names.

Relationship

Review

Condition lifecycle relationship

Z85.028
Personal history of other malignant neoplasm of stomach
C16.4
Malignant neoplasm of pylorus

Personal-history or screening code versus the active disease.

Active disease for this site (stomach)

A personal-history code describes a condition that no longer exists and is no longer being treated, so it is not interchangeable with the active-disease code for the same site.

Source: CMS Table of Neoplasms (site match derived from the code title)

Can these codes be reported together?

History or screening versus active disease. Z85.028 is the personal-history or screening code for the active disease C16.4 names.

Site match derived from the code’s own title against the CMS Table of Neoplasms. A personal-history code describes a condition that no longer exists and is no longer being treated, so it is not interchangeable with the active-disease code.

Side by side

C16.4Malignant neoplasm of pylorusZ85.028Personal history of other malignant neoplasm of stomach
Billing statusBillableBillable
ClassificationC00-D49 — Neoplasms (C00-D49)Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99)
DefinitionMalignant neoplasm of pylorus is a billable ICD-10-CM diagnosis code (C16.4).Personal history of other malignant neoplasm of stomach is a billable ICD-10-CM diagnosis code (Z85.028).
Includes
Malignant neoplasm of prepylorus
Malignant neoplasm of pyloric canal
Conditions classifiable to C16
Use additional code
code to identify:
alcohol abuse and dependence (F10.-)
code to identify:
alcohol use and dependence (F10.-)
exposure to environmental tobacco smoke (Z77.22)
Code first
any follow-up examination after treatment of malignant neoplasm (Z08)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources