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Z90.1 ICD-10-CM Code: Acquired absence of breast and nipple

Z90.1 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupZ90.1

FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)

Z90.1

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Acquired absence of breast and nipple

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

N/A

—

Not mapped

CMS-HCC V24

N/A

—

Not mapped

ACA/HHS

N/A

—

Not mapped

ESRD/PACE

N/A

—

Not mapped

RXHCC

N/A

—

Not mapped

Code Book Path

Official
Z90Acquired absence of organs, not elsewhere classifiedZ90.1Acquired absence of breast and nipple

Inclusion Terms

Official

No inclusion terms are included in this display for Z90.1. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • postprocedural absence of endocrine glands (E89.-)Inherited from Z90

Related Codes

Official
Z90.10Acquired absence of unspecified breast and nippleZ90.11Acquired absence of right breast and nippleZ90.12Acquired absence of left breast and nippleZ90.13Acquired absence of bilateral breasts and nipples

Includes

Official
  • postprocedural or post-traumatic loss of body part NECInherited from Z90

Excludes 1

Official
  • congenital absence - see Alphabetical IndexInherited from Z90

Code First

Official

No Code First sequencing instructions are included in this display for Z90.1. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for Z90.1. Check the code and parent instructions in the Code Book.

Code Also

Official
  • any follow-up examination (Z08-Z09)Inherited from Z77-Z99

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
Z90.1
Description
Acquired absence of breast and nipple
HCC (V28)
No CMS-HCC V28 mapping
RAF reference coefficient
—
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

Z90.1 is the ICD-10-CM diagnosis code for acquired absence of breast and nipple. Z90.1 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons with potential health hazards related to family and personal history and certain conditions influencing health status (z77-z99).

Header codes like Z90.1 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for Z90.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Z90.10Acquired absence of unspecified breast and nipple
Z90.11Acquired absence of right breast and nipple
Z90.12Acquired absence of left breast and nipple
Z90.13Acquired absence of bilateral breasts and nipples

Code Hierarchy

└Z90Acquired absence of organs, not elsewhere classified└Z90.1Acquired absence of breast and nipple
└Z90.1Acquired absence of breast and nipple

Also searched as

  • Z90 1
  • Z901

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