Z42.1

Billable

Encounter for breast reconstruction following mastectomy

Z42.1 is the ICD-10-CM code for Encounter for breast reconstruction following mastectomy. It is a billable, specific code valid for reimbursement.

Status
Billable
Chapter
Z00-Z99
Parent
Z42
Edition
FY2026

Z00-Z99 Factors influencing health status and contact with health services

What this means — in plain language

MedlinePlus · NIH

If you need a mastectomy , you have a choice about whether or not to have surgery to rebuild the shape of the breast. Instead of breast reconstruction, you could choose to wear a breast form that replaces the breast, wear padding inside your bra, or do nothing. All of these options have pros and cons. What is right for one woman may not be right for another. Breast reconstruction may be done at the same time as the…

Read more about Breast Reconstruction at MedlinePlus ↗

Source: U.S. National Library of Medicine (MedlinePlus). Informational only — not medical advice.

Excludes1 — not coded here

  • deformity and disproportion of reconstructed breast (N65.1-)

Frequently asked questions

What is ICD-10 code Z42.1?
Z42.1 is the ICD-10-CM code for "Encounter for breast reconstruction following mastectomy". It falls under Z00-Z99 Factors influencing health status and contact with health services.
Is Z42.1 a billable code?
Yes — Z42.1 is a billable, specific ICD-10-CM code valid for reimbursement.
What is excluded from Z42.1?
Excludes1 (not coded here): deformity and disproportion of reconstructed breast (N65.1-).

Source: CMS ICD-10-CM FY2026. For informational purposes only — not medical advice. See our medical disclaimer.

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