ICD-10 Code Z40.01

Encounter for prophylactic removal of breast

Version 2019 Billable Code
ICD-10: Z40.01
Short Description:Encounter for prophylactic removal of breast
Long Description:Encounter for prophylactic removal of breast

Valid for Submission

ICD-10 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 2019 for the submission of HIPAA-covered transactions.

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)

Information for Medical Professionals

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). The diagnosis code Z40.01 is grouped in the following groups for version MS-DRG V36.0 applicable from 10/01/2018 through 09/30/2019.

  • 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

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • V50.41 - Prphylct orgn rmvl brst

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:


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

  • Breast lump removal (Medical Encyclopedia)
  • Mastectomy (Medical Encyclopedia)
  • Mastectomy - discharge (Medical Encyclopedia)

[Learn More]

ICD-10 Footnotes

General Equivalence Map Definitions
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.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.