A primary-care preventive visit documents that the patient’s mother had breast cancer; the patient has no personal history of malignancy. Which history concept is correct?
Select an answer to reveal the explanation.
Short Explanation
Whose cancer is it—that’s the whole game. Mom’s breast cancer is family history for the patient, not the patient’s personal history. Don’t promote a relative’s diagnosis into the patient’s active or personal-history bucket.
Full Explanation
Personal history Z-codes describe the patient’s own past conditions; family history Z-codes describe disease in relatives. Documentation that a mother had breast cancer supports a family history code, not a personal history or active malignancy code for the patient. Family history may be clinically relevant for screening encounters and is reportable when documented. Coders must not assign active cancer codes from family history alone.