Z42.1
BillableEncounter for breast reconstruction following mastectomy
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A visit for breast reconstruction surgery following a mastectomy (surgical removal of breast tissue), typically performed to restore appearance after cancer treatment.
Coding Tips
- •This code is specifically for reconstruction after mastectomy; ensure the mastectomy was previously performed
- •Document whether this is immediate or delayed reconstruction, as this may affect billing and clinical management
Excludes 1 — Do NOT code together
- deformity and disproportion of reconstructed breast (N65.1-)
Code Hierarchy
└Z42Encounter for plastic and reconstructive surgery following medical procedure or healed injury└Z42.1Encounter for breast reconstruction following mastectomy
└Z42.1Encounter for breast reconstruction following mastectomy