Encounter for prophylactic surgery (Z40) ICD-10-CM
The Z40 code range covers encounter for prophylactic surgery with 12 ICD-10-CM diagnosis codes. 9 of them are billable and valid for claim submission in fiscal year 2026, and the category headers group them but cannot themselves be billed.
Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- organ donations Z52
- therapeutic organ removal-code to condition
Codes in the Z40 Range 12 codes · 9 billable
- Z40 Encounter for prophylactic surgeryNon-billable
- Z40.0 Encounter for prophylactic surgery for risk factors related to malignant neoplasmsNon-billable
- Z40.00 Encounter for prophylactic removal of unspecified organ
- Z40.01 Encounter for prophylactic removal of breast
- Z40.02 Encounter for prophylactic removal of ovary(s)
- Z40.03 Encounter for prophylactic removal of fallopian tube(s)
- Z40.09 Encounter for prophylactic removal of other organ
- Z40.8 Encounter for other prophylactic surgeryNon-billable
- Z40.81 Encounter for prophylactic surgery for removal of ovary(s) for persons without known genetic/familial risk factors New
- Z40.82 Encounter for prophylactic surgery for removal of fallopian tube(s) for persons without known genetic/familial risk factors New
- Z40.89 Encounter for other prophylactic surgery New
- Z40.9 Encounter for prophylactic surgery, unspecified
About the Z40 Code Range
The ICD-10 code Z40 series is used to report patient encounters specifically for prophylactic surgery, which involves preventive removal of organs or tissues to reduce the risk of developing cancer. This includes surgeries like preventive mastectomy or oophorectomy performed before any cancer diagnosis.
These codes cover various types of prophylactic operations, such as Z40.01 for prophylactic removal of the breast, Z40.02 for ovary removal, and Z40.03 for fallopian tube removal. The general Z40.0 code indicates prophylactic surgery addressing risk factors related to malignant neoplasms. Codes like Z40.00 and Z40.09 apply to the removal of unspecified or other organs as a preventive measure. The codes Z40.8 and Z40.9 allow documentation when the specific prophylactic surgery type is other or unspecified. These codes assist healthcare providers and coders in accurately documenting encounters aimed at cancer risk reduction through surgery, often linked to conditions like familial cancer syndromes. Using the correct ICD-10 code for prophylactic surgery ensures precise medical recordkeeping and billing related to preventive surgical care.
Questions About This Page
How many billable codes are in the Z40 range?
Of the 12 codes in this range, 9 are billable and valid for claim submission from October 1, 2025 through September 30, 2026. Category header codes group them but cannot be reported on claims.
What does the Z40 range classify?
The range classifies encounter for prophylactic surgery. Each code links to its own reference page with billing status, MS-DRG grouping, coding notes, and clinical information.
Related References
Source: CMS FY 2026 ICD-10-CM Tabular List and order file, effective October 1, 2025 through September 30, 2026.
