2027 ICD-10-CM Diagnosis Code Z90.12Acquired absence of left breast and nipple

ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z90

ICD-10-CM Z90.12
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Z90.12 is a billable ICD-10-CM diagnosis code for acquired absence of left breast and nipple. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. The code is exempt from POA reporting. Coders also document this condition as acquired absence of breast. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Acquired absence of limb or organ.

Code Identity

ICD-10-CM Code
Z90.12
Billable Status
Yes — Valid for Submission
Code Describes
Acquired absence of left breast and nipple
Short Description
Acquired absence of left breast and nipple
Same as the full description in the CMS dataset.
Parent Code
Z90.1
Acquired absence of breast and nipple

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ77-Z99Persons with potential health hazards related to family and personal history and certain conditions influencing health status
CategoryZ90Acquired absence of organs, not elsewhere classified
This CodeZ90.12Acquired absence of left breast and nipple

Present on Admission (POA)Billing

Z90.12 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Acquired absence of breast
  • Acquired total absence of breast
  • Acquired total absence of left breast
  • History of excision of left nipple
  • History of left mastectomy
  • History of mastectomy
  • History of prophylactic mastectomy
  • History of prophylactic mastectomy of left breast

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Z90.12: its own notes plus those printed at Z90, block Z77-Z99, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Z90 Acquired absence of organs, not elsewhere classified applies to 22 codes
  • postprocedural or post-traumatic loss of body part NEC

Excludes1

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

From Z90 Acquired absence of organs, not elsewhere classified applies to 22 codes
  • congenital absence - see Alphabetical Index

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 Z90 Acquired absence of organs, not elsewhere classified applies to 22 codes
  • postprocedural absence of endocrine glands (E89.-)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From Block Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status applies to 567 codes
  • any follow-up examination (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 Z90.12, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming Z90.12: its condition is not part of those codes, and both may be reported when the patient has both.

  • M95 Other acquired deformities of musculoskeletal system and connective tissue
    acquired absence of limbs and organs (Z89-Z90) names Z89-Z90, which includes this code

Use Additional Code 1

These codes say to use an additional code from the note, and Z90.12 is one of the codes named.

  • Z08 Encounter for follow-up examination after completed treatment for malignant neoplasm
    code to identify any acquired absence of organs (Z90.-) names Z90.-, which includes this code

Clinical ClassificationClinical

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

CCSR FAC022
Acquired absence of limb or organ
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 Z90.12 to ICD-9-CMHistory

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

ICD-9-CM
V45.71 Acq absnce breast/nipple
Approximate The match is approximate rather than exact.

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 Z90.12Overview

What is the ICD-10 code for acquired absence of left breast and nipple?

The ICD-10-CM code for acquired absence of left breast and nipple is Z90.12 (sometimes written as Z9012). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is Z90.12 (Acquired absence of breast and nipple) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report acquired absence of left breast and nipple on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Z90.12 group to?

When acquired absence of left breast and nipple is the principal diagnosis on an inpatient stay, it groups to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.

Is Z90.12 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 acquired absence of left breast and nipple on inpatient claims. The code appears in the Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99) range of the CMS exempt list.

What is the ICD-9 equivalent of Z90.12?

Under the General Equivalence Mappings, acquired absence of left breast and nipple converts to ICD-9-CM V45.71 (acq absnce breast/nipple). The mapping is approximate, so confirm the match fits the documentation.