2026 ICD-10-CM Diagnosis Code Z40.01Encounter for prophylactic removal of breast

ICD-10-CM Codes›Z00–Z99›Z40-Z53›Z40

ICD-10-CM Z40.01
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z40.01 is a billable ICD-10-CM diagnosis code for encounter for prophylactic removal of breast. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 600 through 601. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Encounter for prophylactic or other procedures.

Code Identity

ICD-10-CM Code
Z40.01
Billable Status
Yes — Valid for Submission
Code Describes
Encounter for prophylactic removal of breast
Short Description
Encounter for prophylactic removal of breast
Same as the full description in the CMS dataset.
Parent Code
Z40.0
Encounter for prophylactic surgery for risk factors related to malignant neoplasms

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ40-Z53Encounters for other specific health care
CategoryZ40Encounter for prophylactic surgery
This CodeZ40.01Encounter for prophylactic removal of breast

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Admission(for)
      • prophylactic (measure)
        • organ removal
          • breast
    • Prophylactic
      • organ removal (for neoplasia management)
        • breast

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR FAC004
Encounter for prophylactic or other procedures
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Mastectomy

A mastectomy is surgery to remove part or all of the breast. It's usually done to treat breast cancer by removing the cancer. A mastectomy may be the first treatment option for some types of breast cancer or done after chemotherapy for other types.

The full article covers:

  • What is a mastectomy?
  • What are the different types of mastectomies?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Z40.01 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V50.41 Prphylct orgn rmvl brst
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z40.01Overview

Is Z40.01 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report encounter for prophylactic removal of breast on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Z40.01 group to?

When encounter for prophylactic removal of breast is the principal diagnosis on an inpatient stay, it groups to MS-DRG 600, 601, with relative weights from 0.6050 to 1.0416 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of Z40.01?

Under the General Equivalence Mappings, encounter for prophylactic removal of breast converts to ICD-9-CM V50.41 (prphylct orgn rmvl brst). The mapping is a direct match.