2027 ICD-10-CM Diagnosis Code Z42.8Encounter for other plastic and reconstructive surgery following medical procedure or healed injury
Z42.8 is a billable ICD-10-CM diagnosis code for encounter for other plastic and reconstructive surgery following medical procedure or healed injury. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 606 through 607. 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
Z42.8 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 Z42.8: its own notes plus those printed at Z42, 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.
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 Z42.8, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming Z42.8: they are not reported together with it, unless the two conditions are unrelated.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Admission (for) See Also: Encounter (for);
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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.
Convert Z42.8 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z42.8Overview
Is Z42.8 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report encounter for other plastic and reconstructive surgery following medical procedure or healed injury on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z42.8 group to?
When encounter for other plastic and reconstructive surgery following medical procedure or healed injury is the principal diagnosis on an inpatient stay, it groups to MS-DRG 607, 606, with relative weights from 0.8772 to 1.5721 depending on complications. Higher weights mean higher Medicare reimbursement.
Is Z42.8 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 other plastic and reconstructive surgery following medical procedure or healed injury on inpatient claims. The code appears in the Encounters for other specific health care (Z40-Z53) range of the CMS exempt list.
Can Z42.8 be reported with Z41.1?
Not as a rule. The Excludes1 note at Z42, which applies to Z42.8, 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).
What is the ICD-9 equivalent of Z42.8?
Under the General Equivalence Mappings, encounter for other plastic and reconstructive surgery following medical procedure or healed injury converts to ICD-9-CM V51.8 (aftercre plastc surg NEC). The mapping is approximate, so confirm the match fits the documentation.
