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ICD-10/Z86.16

Z86.16 ICD-10-CM Code: Personal history of COVID-19

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Personal history of COVID-19 is a billable ICD-10-CM diagnosis code (Z86.16).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for Z86.16 in the official ICD-10-CM tabular list.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

  • post COVID-19 condition (U09.9)
  • personal history of infectious diseases specific to a body system
  • sequelae of infectious and parasitic diseases (B90-B94) Compare Z86.16 vs B90 →

Code First

Underlying conditions that must be sequenced before this code.

  • any follow-up examination after treatment (Z09)

Code Also

Additional codes that may be required to fully describe the encounter.

  • any follow-up examination (Z08-Z09)

Change history

  • FY2022 — 2021-10-01
    Added to the code set
    Personal history of COVID-19
    FY2022 changes

Verify Before Coding

  • Billable — reportable as written.
  • Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Referenced by Other Codes

Clinical classification (AHRQ CCSR):FAC030 — Personal history of other disease (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 1 MS-DRG: DRG 951 (MDC 23).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name Z86.16 or its code family.

1 Excludes2 notes: Z20 (via Z86.1.-).

2 Use Additional Code instructions across 2 chapters: M35.81, Z09 (via Z86.-).

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Z86.16 in its code family, with their registry titles.

  • Z86.11 — Personal history of tuberculosis
  • Z86.12 — Personal history of poliomyelitis
  • Z86.13 — Personal history of malaria
  • Z86.14 — Personal history of Methicillin resistant Staphylococcus aureus infection
  • Z86.15 — Personal history of latent tuberculosis infection
  • Z86.17 — Personal history of Clostridioides difficile infection
  • Z86.19 — Personal history of other infectious and parasitic diseases
  • Z86.2 — Personal history of diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
  • Z86.3 — Personal history of endocrine, nutritional and metabolic diseases
  • Z86.31 — Personal history of diabetic foot ulcer

View all codes in the Z86 family

Indexed Clinical Terms (10)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • COVID-19, history of (personal)
  • History, personal (of), coronavirus2019 (disease) (novel)
  • History, personal (of), COVID-19
  • History, personal (of), disease or disorder (of), infectious, coronavirus2019 (disease) (novel)
  • History, personal (of), disease or disorder (of), infectious, COVID-19
  • History, personal (of), disease or disorder (of), infectious, SARS-CoV-2
  • History, personal (of), infection NEC, coronavirus2019 (disease) (novel)
  • History, personal (of), infection NEC, COVID-19
  • History, personal (of), infection NEC, SARS-CoV-2
  • History, personal (of), SARS-CoV-2 infection