Z40.01
Encounter for prophylactic removal of breast
This code does not map to a risk-adjusting HCC in the loaded models.
Coding notes
Excludes 1 never coded together · Excludes 2 may co-exist
code to identify risk factor, such as genetic susceptibility to malignant neoplasm Z15.-
Admission for prophylactic organ removal
organ donations (Z52.-) therapeutic organ removal-code to condition
follow-up examination for medical surveillance after treatment (Z08-Z09)
Categories Z40-Z53 are intended for use to indicate a reason for care. They may be used for patients who have already been treated for a disease or injury, but who are receiving aftercare or prophylactic care, or care to consolidate the treatment, or to deal with a residual state
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.
Official Guidelines for Z40.01
FY 2026 ›Sections that reference Z40.01
- I.C.21.c.13)Miscellaneous Z Codes
… susceptibility to cancer or a family history of cancer), the principal or first-listed code should be a code from subcategory Z40.0, Encounter for prophylactic surgery for risk factors related to malignant neoplasms, or subcategory Z40.8, Encounter for other …
- I.C.21.c.15)Z Codes That May Only be Principal/First-Listed Diagnosis
… Encounter for maternal postpartum care and examination Z38 Liveborn infants according to place of birth and type of delivery Z40 Encounter for prophylactic surgery Z42 Encounter for plastic and reconstructive surgery following medical procedure or healed …
- I.B.3Code or codes from A00.0 through T88.9, Z00-Z99.8, U00-U85Conventions & general rules
The appropriate code or codes from A00.0 through T88.9, Z00-Z99.8, and U00-U85 must be used to identify diagnoses, symptoms, conditions, problems, complaints or other reason(s) for the …
- I.C.20.a.1)Used with any code in the range of A00.0-T88.9, Z00-Z99Chapter 20
An external cause code may be used with any code in the range of A00.0-T88.9, Z00-Z99, classification that represents a health condition due to an external cause. …
- IV.BCodes from A00.0 through T88.9, Z00-Z99, U00-U85Outpatient services
The appropriate code(s) from A00.0 through T88.9, Z00-Z99 and U00-U85 must be used to identify diagnoses, symptoms, conditions, problems, complaints, or other reason(s) for the …
- IV.EEncounters for circumstances other than a disease or injuryOutpatient services
… The Factors Influencing Health Status and Contact with Health Services codes (Z00- Z99) are provided to deal with occasions when circumstances other than a disease or injury are recorded as diagnosis or problems. …
Sections whose FY 2026 text names Z40.01, its Z40 category, or a range containing it — the chapter guidance above is the authoritative source.
Find Z40.01 in the alphabetic index
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