Z42

Non-Billable
ChapterZ00–Z99
Rankcategory
Official Description

Encounter for plastic and reconstructive surgery following medical procedure or healed injury

Metadata & Insights
  • Non-billable category (requires more specific sub-code).
  • Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00-Z99).

Z40-Z53 Parent Instructions

Includes
  • 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)

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

Clinical Hierarchy

BillableHas subcodes
CH21Factors influencing health status and contact with health services (Z00-Z99)
Z40-Z53Encounters for other specific health care (Z40-Z53)
Z42Encounter for plastic and reconstructive surgery following medical procedure or healed injuryNot billable
Z42.1Encounter for breast reconstruction following mastectomyBillable
Z42.8Encounter for other plastic and reconstructive surgery following medical procedure or healed injuryBillable

Applicable Ancestor Context

The following parent sections contain instructions or notes that apply to Z42:

blockZ40-Z53
Encounters for other specific health care (Z40-Z53)
View context instructions

MS-DRG Classification

2026

No direct MS-DRG triggers identified.

Cross Reference

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