Is Z42.1 a billable ICD-10 code?

Yes. Z42.1 (Encounter for breast reconstruction following mastectomy) is billable and can be used for insurance claims. Always verify payer-specific requirements.

Z42.1 ✓ Billable

Encounter for breast reconstruction following mastectomy

Q: What is ICD-10 code Z42.1?

ICD-10-CM code Z42.1 stands for "Encounter for breast reconstruction following mastectomy". It is a billable code in the Factors Influencing Health Status chapter, effective FY2026 (Oct 1, 2025 – Sep 30, 2026).

ICD-10-CM · FY2026 · Factors Influencing Health Status

Code

Z42.1

System

ICD-10-CM

Billable

Yes — valid for submission

Effective

FY2026

Chapter

Factors Influencing Health Status

Source

CMS / CDC NCHS

⚠ Verify before billing. Confirm against the current CMS/NCHS ICD-10-CM files and your payer's rules before claims submission.

Frequently asked questions

What is ICD-10 code Z42.1?

ICD-10-CM code Z42.1 represents Encounter for breast reconstruction following mastectomy. It is a billable diagnosis code in the Factors Influencing Health Status chapter, effective October 1, 2025 – September 30, 2026.

Is Z42.1 billable?

Yes. Z42.1 is a valid billable ICD-10-CM code for insurance claims and clinical documentation.

What chapter is Z42.1 in?

Z42.1 belongs to the Factors Influencing Health Status chapter (Z00–Z99) of ICD-10-CM.

Related codes in the Z42 category

Z42 Encounter for plastic and reconstructive surgery following medical procedure or healed injury Non-billable Z42.8 Encounter for other plastic and reconstructive surgery following medical procedure or healed injury Billable

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