2027 ICD-10-CM Diagnosis Code Z42Encounter for plastic and reconstructive surgery following medical procedure or healed injury

ICD-10-CM Codes›Z00–Z99›Z40-Z53›Z42

ICD-10-CM Z42
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Z42 is a non-billable ICD-10-CM category code for encounter for plastic and reconstructive surgery following medical procedure or healed injury, so it cannot be submitted on claims. Use a more specific code from this category instead, such as Z42.1 and Z42.8.

Code Identity

ICD-10-CM Code
Z42
Billable Status
No — Non-Billable Category
Code Describes
Encounter for plastic and reconstructive surgery following medical procedure or healed injury
Short Description
Encntr for plast/recnst surg fol med proc or healed injury
Chapter
Z40-Z53
Encounters for other specific health care

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ40-Z53Encounters for other specific health care
CategoryZ42Encounter for plastic and reconstructive surgery following medical procedure or healed injury
This CodeZ42Encounter for plastic and reconstructive surgery following medical procedure or healed injury

Specific Coding for Encntr for plast/recnst surg fol med proc or healed injuryOverview

Non-specific codes like Z42 require more characters. Use one of these billable codes instead:

  • Use Z42.1 for Encounter for breast reconstruction following mastectomy

  • Use Z42.8 for Encounter for other plastic and reconstructive surgery following medical procedure or healed injury

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Z42: its own notes plus those printed at block Z40-Z53 and Chapter 21. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

  • encounter for cosmetic plastic surgery (Z41.1)
  • encounter for plastic surgery for treatment of current injury - code to relevent injury

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.

From Block Z40-Z53 Encounters for other specific health care applies to 164 codes
  • follow-up examination for medical surveillance after treatment (Z08-Z09)

Notes

General instructions on how these codes are used.

From Chapter 21 (Z00-Z99) Factors influencing health status and contact with health services applies to 1,425 codes
  • 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 Z42, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming Z42: they are not reported together with it, unless the two conditions are unrelated.

  • Z41.1 Encounter for cosmetic surgery
    encounter for plastic and reconstructive surgery following medical procedure or healed injury (Z42.-)

Patient EducationClinical

Plastic and Cosmetic Surgery

Surgeons can reshape the appearance of body parts through cosmetic surgery. Some of the most common body parts people want to improve through surgery include:

Read the full article at MedlinePlus

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

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Z42Overview

Is Z42 a billable code?

No. This is a category header that groups the codes for encounter for plastic and reconstructive surgery following medical procedure or healed injury, and headers cannot be submitted on claims. Claims for encounter for plastic and reconstructive surgery following medical procedure or healed injury need a more specific code from this category, such as Z42.1 and Z42.8.

Can Z42 be reported with Z41.1?

Not as a rule. The Excludes1 note on Z42 lists "encounter for cosmetic plastic surgery (Z41.1)". 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).