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Z41.1

Billable

Encounter for cosmetic surgery

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A visit for elective cosmetic or aesthetic surgery to improve appearance, such as facelifts, liposuction, or breast augmentation.

Coding Tips

  • •Cosmetic procedures are typically not covered by insurance; verify medical necessity vs. purely cosmetic intent
  • •Document whether the procedure is reconstructive (covered) or purely cosmetic (not covered)

Excludes 1 — Do NOT code together

  • encounter for plastic and reconstructive surgery following medical procedure or healed injury (Z42.-)
  • encounter for post-mastectomy breast implantation (Z42.1)

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