Encounter for plastic and reconstructive surgery following medical procedure or healed injury
In Encounters for other specific health care (Z40-Z53), chapter 21: Factors Influencing Health Status and Contact with Health Services
2 billable codes under Z42: none are a CC or MCC; none map to an HCC.
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Instructional notes
Excludes1: not coded here, use a different code
- encounter for cosmetic plastic surgery (Z41.1)
- encounter for plastic surgery for treatment of current injury - code to relevent injury
Also applies, from Encounters for other specific health care (Z40-Z53)
These notes sit on Z40-Z53 and apply to every code under it, including Z42.
Includes: conditions that are coded here
- Categories Z40-Z53 are intended for use to indicate a reason for care. They may be used for patients who have already been treated for a disease or injury, but who are receiving aftercare or prophylactic care, or care to consolidate the treatment, or to deal with a residual state
Excludes2: not included here, code separately if applicable
- follow-up examination for medical surveillance after treatment (Z08-Z09)
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Covers when and how to use Z codes (Z00-Z99) for encounters and supplementary information, including contact, status, history, screening, aftercare, exams, and social determinants of health.
All codes under Z42
Z42 can't be used on a claim. Pick a billable code below; grey headings group them.
Z42 MS-DRGs
As the principal diagnosis, all 2 billable codes under Z42 group to MS-DRG 606 or 607 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
Other codes that refer to Z42
Notes on these codes point to Z42.
- Z41.1 Excludes1: encounter for plastic and reconstructive surgery following medical procedure or healed injury (Z42.-)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Plastic and Cosmetic Surgery
Surgeons can reshape the appearance of body parts through cosmetic surgery. Some of the most common body parts people want to improve through surgery include:
Read more about plastic and cosmetic surgery on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.