ICD-10 Diagnosis Code Z42.1

Encounter for breast reconstruction following mastectomy

Diagnosis Code Z42.1

ICD-10: Z42.1
Short Description: Encounter for breast reconstruction following mastectomy
Long Description: Encounter for breast reconstruction following mastectomy
This is the 2017 version of the ICD-10-CM diagnosis code Z42.1

Code Classification
  • Factors influencing health status and contact with health services
    • Encounters for other specific health care (Z40-Z53)
      • Encntr for plast/recnst surg fol med proc or healed injury (Z42)

Information for Medical Professionals

Code Edits
The following edits are applicable to this code:
Adult diagnoses Additional informationCallout TooltipAdult diagnoses
Adult. Age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

Diagnostic Related Groups
The diagnosis code Z42.1 is grouped in the following Diagnostic Related Group(s) (MS-DRG v33.0)


Convert to ICD-9 Additional informationCallout TooltipGeneral Equivalence Map
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
  • V51.0 - Brst reconst fol mastect

Present on Admission (POA) Additional informationCallout TooltipPresent on Admission
The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.

The code Z42.1 is exempt from POA reporting.

Index of Diseases and Injuries
References found for the code Z42.1 in the Index of Diseases and Injuries:

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