ICD-10-CM Code Z40.01

Encounter for prophylactic removal of breast

Version 2020 Billable Code

Valid for Submission

Z40.01 is a billable code used to specify a medical diagnosis of encounter for prophylactic removal of breast. The code is valid for the year 2020 for the submission of HIPAA-covered transactions.

ICD-10:Z40.01
Short Description:Encounter for prophylactic removal of breast
Long Description:Encounter for prophylactic removal of breast

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z40.01 are found in the index:


Diagnostic Related Groups

The ICD-10 code Z40.01 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2020 through 09/30/2020.

  • 597 - MALIGNANT BREAST DISORDERS WITH MCC
  • 598 - MALIGNANT BREAST DISORDERS WITH CC
  • 599 - MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
  • 600 - NON-MALIGNANT BREAST DISORDERS WITH CC/MCC
  • 601 - NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Convert Z40.01 to ICD-9

  • V50.41 - Prphylct orgn rmvl brst

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Encounters for other specific health care (Z40-Z53)
      • Encounter for prophylactic surgery (Z40)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Mastectomy

A mastectomy is surgery to remove a breast or part of a breast. It is usually done to treat breast cancer. Types of breast surgery include

  • Total (simple) mastectomy - removal of breast tissue and nipple
  • Modified radical mastectomy - removal of the breast, most of the lymph nodes under the arm, and often the lining over the chest muscles
  • Lumpectomy - surgery to remove the tumor and a small amount of normal tissue around it

Which surgery you have depends on the stage of cancer, size of the tumor, size of the breast, and whether the lymph nodes are involved. Many women have breast reconstruction to rebuild the breast after a mastectomy.

Sometimes mastectomy is done to prevent breast cancer. Only high-risk patients have this type of surgery.

NIH: National Cancer Institute


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