2027 ICD-10-CM Diagnosis Code Z40.81Encounter for prophylactic surgery for removal of ovary(s) for persons without known genetic/familial risk factors
Z40.81 is a billable ICD-10-CM diagnosis code for encounter for prophylactic surgery for removal of ovary(s) for persons without known genetic/familial risk factors. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 742 through 743, 760 through 761. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Encounter for prophylactic or other procedures.
Code Identity
Code Classification
Present on Admission (POA)Billing
Z40.81 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Encounters for other specific health care (Z40-Z53).
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z40.81: its own notes plus those printed at Z40, block Z40-Z53, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Encounter for prophylactic oophorectomy for persons without known genetic/ familial risk factors
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Notes
General instructions on how these codes are used.
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Z40.81, its category, or a range that includes it.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Admission (for) See Also: Encounter (for);
prophylactic (measure) See Also: Encounter, prophylactic measures;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Code History & ChangesHistory
Replacement Z40.81 replaces the following previously assigned code(s):
- Z40.8 - Encounter for other prophylactic surgery
Questions About Z40.81Overview
Is Z40.81 (Encounter for other prophylactic surgery) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report encounter for prophylactic surgery for removal of ovary(s) for persons without known genetic/familial risk factors on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z40.81 group to?
When encounter for prophylactic surgery for removal of ovary(s) for persons without known genetic/familial risk factors is the principal diagnosis on an inpatient stay, it groups to MS-DRG 742, 743, 760, 761, with relative weights from 0.7039 to 1.8448 depending on complications. Higher weights mean higher Medicare reimbursement.
Is Z40.81 exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for encounter for prophylactic surgery for removal of ovary(s) for persons without known genetic/familial risk factors on inpatient claims. The code appears in the Encounters for other specific health care (Z40-Z53) range of the CMS exempt list.
Can Z40.81 be reported with a code from Z52?
Not as a rule. The Excludes1 note at Z40, which applies to Z40.81, lists "organ donations (Z52.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
