Encounters for other specific health care (Z40-Z53)

Z40Encounter for prophylactic surgery
Excludes 1: organ donations (Z52.-)
› therapeutic organ removal-code to condition

Z40.0Encounter for prophylactic surgery for risk factors related to malignant neoplasms
› Admission for prophylactic organ removal
Use Additional Code: code to identify risk factor

Z40.00Encounter for prophylactic removal of unspecified organ

Z40.01Encounter for prophylactic removal of breast

Z40.02Encounter for prophylactic removal of ovary(s)
› Encounter for prophylactic removal of ovary(s) and fallopian tube(s)

Z40.03Encounter for prophylactic removal of fallopian tube(s)

Z40.09Encounter for prophylactic removal of other organ

Z40.8Encounter for other prophylactic surgery

Z40.9Encounter for prophylactic surgery, unspecified

Z41Encounter for procedures for purposes other than remedying health state

Z41.1Encounter for cosmetic surgery
› Encounter for cosmetic breast implant
› Encounter for cosmetic procedure
Excludes 1: encounter for plastic and reconstructive surgery following medical procedure or healed injury (Z42.-)
› encounter for post-mastectomy breast implantation (Z42.1)

Z41.2Encounter for routine and ritual male circumcision

Z41.3Encounter for ear piercing

Z41.8Encounter for other procedures for purposes other than remedying health state

Z41.9Encounter for procedure for purposes other than remedying health state, unspecified

Z42Encounter for plastic and reconstructive surgery following medical procedure or healed injury
Excludes 1: encounter for cosmetic plastic surgery (Z41.1)
› encounter for plastic surgery for treatment of current injury - code to relevent injury

Z42.1Encounter for breast reconstruction following mastectomy
Excludes 1: deformity and disproportion of reconstructed breast (N65.1-)

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

Z43Encounter for attention to artificial openings
Includes: closure of artificial openings
› passage of sounds or bougies through artificial openings
› reforming artificial openings
› removal of catheter from artificial openings
› toilet or cleansing of artificial openings
Excludes 1: complications of external stoma (J95.0-, K94.-, N99.5-)
Excludes 2: fitting and adjustment of prosthetic and other devices (Z44-Z46)

Z43.0Encounter for attention to tracheostomy

Z43.1Encounter for attention to gastrostomy
Excludes 2: artificial opening status only, without need for care (Z93.-)

Z43.2Encounter for attention to ileostomy

Z43.3Encounter for attention to colostomy

Z43.4Encounter for attention to other artificial openings of digestive tract

Z43.5Encounter for attention to cystostomy

Z43.6Encounter for attention to other artificial openings of urinary tract
› Encounter for attention to nephrostomy
› Encounter for attention to ureterostomy
› Encounter for attention to urethrostomy

Z43.7Encounter for attention to artificial vagina

Z43.8Encounter for attention to other artificial openings

Z43.9Encounter for attention to unspecified artificial opening

Z44Encounter for fitting and adjustment of external prosthetic device
Includes: removal or replacement of external prosthetic device
Excludes 1: malfunction or other complications of device - see Alphabetical Index
› presence of prosthetic device (Z97.-)

Z44.0Encounter for fitting and adjustment of artificial arm

Z44.00Encounter for fitting and adjustment of unspecified artificial arm

Z44.001Encounter for fitting and adjustment of unspecified right artificial arm

Z44.002Encounter for fitting and adjustment of unspecified left artificial arm

Z44.009Encounter for fitting and adjustment of unspecified artificial arm, unspecified arm

Z44.01Encounter for fitting and adjustment of complete artificial arm

Z44.011Encounter for fitting and adjustment of complete right artificial arm

Z44.012Encounter for fitting and adjustment of complete left artificial arm

Z44.019Encounter for fitting and adjustment of complete artificial arm, unspecified arm

Z44.02Encounter for fitting and adjustment of partial artificial arm

Z44.021Encounter for fitting and adjustment of partial artificial right arm

Z44.022Encounter for fitting and adjustment of partial artificial left arm

Z44.029Encounter for fitting and adjustment of partial artificial arm, unspecified arm

Z44.1Encounter for fitting and adjustment of artificial leg

Z44.10Encounter for fitting and adjustment of unspecified artificial leg

Z44.101Encounter for fitting and adjustment of unspecified right artificial leg

Z44.102Encounter for fitting and adjustment of unspecified left artificial leg

Z44.109Encounter for fitting and adjustment of unspecified artificial leg, unspecified leg

Z44.11Encounter for fitting and adjustment of complete artificial leg

Z44.111Encounter for fitting and adjustment of complete right artificial leg

Z44.112Encounter for fitting and adjustment of complete left artificial leg

Z44.119Encounter for fitting and adjustment of complete artificial leg, unspecified leg

Z44.12Encounter for fitting and adjustment of partial artificial leg

Z44.121Encounter for fitting and adjustment of partial artificial right leg

Z44.122Encounter for fitting and adjustment of partial artificial left leg

Z44.129Encounter for fitting and adjustment of partial artificial leg, unspecified leg

Z44.2Encounter for fitting and adjustment of artificial eye
Excludes 1: mechanical complication of ocular prosthesis (T85.3)

Z44.20Encounter for fitting and adjustment of artificial eye, unspecified

Z44.21Encounter for fitting and adjustment of artificial right eye

Z44.22Encounter for fitting and adjustment of artificial left eye

Z44.3Encounter for fitting and adjustment of external breast prosthesis
Excludes 1: complications of breast implant (T85.4-)
› encounter for adjustment or removal of breast implant (Z45.81-)
› encounter for initial breast implant insertion for cosmetic breast augmentation (Z41.1)
› encounter for breast reconstruction following mastectomy (Z42.1)

Z44.30Encounter for fitting and adjustment of external breast prosthesis, unspecified breast

Z44.31Encounter for fitting and adjustment of external right breast prosthesis

Z44.32Encounter for fitting and adjustment of external left breast prosthesis

Z44.8Encounter for fitting and adjustment of other external prosthetic devices

Z44.9Encounter for fitting and adjustment of unspecified external prosthetic device

Z45Encounter for adjustment and management of implanted device
Includes: removal or replacement of implanted device
Excludes 1: malfunction or other complications of device - see Alphabetical Index
Excludes 2: encounter for fitting and adjustment of non-implanted device (Z46.-)

Z45.0Encounter for adjustment and management of cardiac device

Z45.01Encounter for adjustment and management of cardiac pacemaker
› Encounter for adjustment and management of cardiac resynchronization therapy pacemaker (CRT-P)
Excludes 1: encounter for adjustment and management of automatic implantable cardiac defibrillator with synchronous cardiac pacemaker (Z45.02)

Z45.010Encounter for checking and testing of cardiac pacemaker pulse generator [battery]
› Encounter for replacing cardiac pacemaker pulse generator [battery]

Z45.018Encounter for adjustment and management of other part of cardiac pacemaker
Excludes 1: presence of other part of cardiac pacemaker (Z95.0)
Excludes 2: presence of prosthetic and other devices (Z95.1-Z95.5, Z95.811-Z97)

Z45.02Encounter for adjustment and management of automatic implantable cardiac defibrillator
› Encounter for adjustment and management of automatic implantable cardiac defibrillator with synchronous cardiac pacemaker
› Encounter for adjustment and management of cardiac resynchronization therapy defibrillator (CRT-D)

Z45.09Encounter for adjustment and management of other cardiac device

Z45.1Encounter for adjustment and management of infusion pump

Z45.2Encounter for adjustment and management of vascular access device
› Encounter for adjustment and management of vascular catheters
Excludes 1: encounter for adjustment and management of renal dialysis catheter (Z49.01)

Z45.3Encounter for adjustment and management of implanted devices of the special senses

Z45.31Encounter for adjustment and management of implanted visual substitution device

Z45.32Encounter for adjustment and management of implanted hearing device
Excludes 1: Encounter for fitting and adjustment of hearing aide (Z46.1)

Z45.320Encounter for adjustment and management of bone conduction device

Z45.321Encounter for adjustment and management of cochlear device

Z45.328Encounter for adjustment and management of other implanted hearing device

Z45.4Encounter for adjustment and management of implanted nervous system device

Z45.41Encounter for adjustment and management of cerebrospinal fluid drainage device
› Encounter for adjustment and management of cerebral ventricular (communicating) shunt

Z45.42Encounter for adjustment and management of neurostimulator
› Encounter for adjustment and management of brain neurostimulator
› Encounter for adjustment and management of gastric neurostimulator
› Encounter for adjustment and management of peripheral nerve neurostimulator
› Encounter for adjustment and management of sacral nerve neurostimulator
› Encounter for adjustment and management of spinal cord neurostimulator
› Encounter for adjustment and management of vagus nerve neurostimulator

Z45.49Encounter for adjustment and management of other implanted nervous system device

Z45.8Encounter for adjustment and management of other implanted devices

Z45.81Encounter for adjustment or removal of breast implant
› Encounter for elective implant exchange (different material) (different size)
› Encounter for removal of tissue expander with or without synchronous insertion of permanent implant
Excludes 1: complications of breast implant (T85.4-)
› encounter for initial breast implant insertion for cosmetic breast augmentation (Z41.1)
› encounter for breast reconstruction following mastectomy (Z42.1)

Z45.811Encounter for adjustment or removal of right breast implant

Z45.812Encounter for adjustment or removal of left breast implant

Z45.819Encounter for adjustment or removal of unspecified breast implant

Z45.82Encounter for adjustment or removal of myringotomy device (stent) (tube)

Z45.89Encounter for adjustment and management of other implanted devices

Z45.9Encounter for adjustment and management of unspecified implanted device

Z46Encounter for fitting and adjustment of other devices
Includes: removal or replacement of other device
Excludes 1: malfunction or other complications of device - see Alphabetical Index
Excludes 2: encounter for fitting and management of implanted devices (Z45.-)
› issue of repeat prescription only (Z76.0)
› presence of prosthetic and other devices (Z95-Z97)

Z46.0Encounter for fitting and adjustment of spectacles and contact lenses

Z46.1Encounter for fitting and adjustment of hearing aid
Excludes 1: encounter for adjustment and management of implanted hearing device (Z45.32-)

Z46.2Encounter for fitting and adjustment of other devices related to nervous system and special senses
Excludes 2: encounter for adjustment and management of implanted nervous system device (Z45.4-)
› encounter for adjustment and management of implanted visual substitution device (Z45.31)

Z46.3Encounter for fitting and adjustment of dental prosthetic device
› Encounter for fitting and adjustment of dentures

Z46.4Encounter for fitting and adjustment of orthodontic device

Z46.5Encounter for fitting and adjustment of other gastrointestinal appliance and device
Excludes 1: encounter for attention to artificial openings of digestive tract (Z43.1-Z43.4)

Z46.51Encounter for fitting and adjustment of gastric lap band

Z46.59Encounter for fitting and adjustment of other gastrointestinal appliance and device

Z46.6Encounter for fitting and adjustment of urinary device
Excludes 2: attention to artificial openings of urinary tract (Z43.5, Z43.6)

Z46.8Encounter for fitting and adjustment of other specified devices

Z46.81Encounter for fitting and adjustment of insulin pump
› Encounter for insulin pump instruction and training
› Encounter for insulin pump titration

Z46.82Encounter for fitting and adjustment of non-vascular catheter

Z46.89Encounter for fitting and adjustment of other specified devices
› Encounter for fitting and adjustment of wheelchair

Z46.9Encounter for fitting and adjustment of unspecified device

Z47Orthopedic aftercare
Excludes 1: aftercare for healing fracture-code to fracture with 7th character D

Z47.1Aftercare following joint replacement surgery
Use Additional Code: code to identify the joint (Z96.6-)

Z47.2Encounter for removal of internal fixation device
Excludes 1: encounter for adjustment of internal fixation device for fracture treatment- code to fracture with appropriate 7th character
› encounter for removal of external fixation device- code to fracture with 7th character D
› infection or inflammatory reaction to internal fixation device (T84.6-)
› mechanical complication of internal fixation device (T84.1-)

Z47.3Aftercare following explantation of joint prosthesis
› Aftercare following explantation of joint prosthesis, staged procedure
› Encounter for joint prosthesis insertion following prior explantation of joint prosthesis

Z47.31Aftercare following explantation of shoulder joint prosthesis
Excludes 1: acquired absence of shoulder joint following prior explantation of shoulder joint prosthesis (Z89.23-)
› shoulder joint prosthesis explantation status (Z89.23-)

Z47.32Aftercare following explantation of hip joint prosthesis
Excludes 1: acquired absence of hip joint following prior explantation of hip joint prosthesis (Z89.62-)
› hip joint prosthesis explantation status (Z89.62-)

Z47.33Aftercare following explantation of knee joint prosthesis
Excludes 1: acquired absence of knee joint following prior explantation of knee prosthesis (Z89.52-)
› knee joint prosthesis explantation status (Z89.52-)

Z47.8Encounter for other orthopedic aftercare

Z47.81Encounter for orthopedic aftercare following surgical amputation
Use Additional Code: code to identify the limb amputated (Z89.-)

Z47.82Encounter for orthopedic aftercare following scoliosis surgery

Z47.89Encounter for other orthopedic aftercare

Z48Encounter for other postprocedural aftercare
Excludes 1: encounter for follow-up examination after completed treatment (Z08-Z09)
› encounter for aftercare following injury - code to Injury, by site, with appropriate 7th character for subsequent encounter
Excludes 2: encounter for attention to artificial openings (Z43.-)
› encounter for fitting and adjustment of prosthetic and other devices (Z44-Z46)

Z48.0Encounter for attention to dressings, sutures and drains
Excludes 1: encounter for planned postprocedural wound closure (Z48.1)

Z48.00Encounter for change or removal of nonsurgical wound dressing
› Encounter for change or removal of wound dressing NOS

Z48.01Encounter for change or removal of surgical wound dressing

Z48.02Encounter for removal of sutures
› Encounter for removal of staples

Z48.03Encounter for change or removal of drains

Z48.1Encounter for planned postprocedural wound closure
Excludes 1: encounter for attention to dressings and sutures (Z48.0-)

Z48.2Encounter for aftercare following organ transplant

Z48.21Encounter for aftercare following heart transplant

Z48.22Encounter for aftercare following kidney transplant

Z48.23Encounter for aftercare following liver transplant

Z48.24Encounter for aftercare following lung transplant

Z48.28Encounter for aftercare following multiple organ transplant

Z48.280Encounter for aftercare following heart-lung transplant

Z48.288Encounter for aftercare following multiple organ transplant

Z48.29Encounter for aftercare following other organ transplant

Z48.290Encounter for aftercare following bone marrow transplant

Z48.298Encounter for aftercare following other organ transplant

Z48.3Aftercare following surgery for neoplasm
Use Additional Code: code to identify the neoplasm

Z48.8Encounter for other specified postprocedural aftercare

Z48.81Encounter for surgical aftercare following surgery on specified body systems
› These codes identify the body system requiring aftercare. They are for use in conjunction with other aftercare codes to fully explain the aftercare encounter. The condition treated should also be coded if still present.
Excludes 1: aftercare for injury- code the injury with 7th character D
› aftercare following surgery for neoplasm (Z48.3)
Excludes 2: aftercare following organ transplant (Z48.2-)
› orthopedic aftercare (Z47.-)

Z48.810Encounter for surgical aftercare following surgery on the sense organs

Z48.811Encounter for surgical aftercare following surgery on the nervous system
Excludes 2: encounter for surgical aftercare following surgery on the sense organs (Z48.810)

Z48.812Encounter for surgical aftercare following surgery on the circulatory system

Z48.813Encounter for surgical aftercare following surgery on the respiratory system

Z48.814Encounter for surgical aftercare following surgery on the teeth or oral cavity

Z48.815Encounter for surgical aftercare following surgery on the digestive system

Z48.816Encounter for surgical aftercare following surgery on the genitourinary system
Excludes 1: encounter for aftercare following sterilization reversal (Z31.42)

Z48.817Encounter for surgical aftercare following surgery on the skin and subcutaneous tissue

Z48.89Encounter for other specified surgical aftercare

Z49Encounter for care involving renal dialysis
Code Also: associated end stage renal disease (N18.6)

Z49.0Preparatory care for renal dialysis
› Encounter for dialysis instruction and training

Z49.01Encounter for fitting and adjustment of extracorporeal dialysis catheter
› Removal or replacement of renal dialysis catheter
› Toilet or cleansing of renal dialysis catheter

Z49.02Encounter for fitting and adjustment of peritoneal dialysis catheter

Z49.3Encounter for adequacy testing for dialysis

Z49.31Encounter for adequacy testing for hemodialysis

Z49.32Encounter for adequacy testing for peritoneal dialysis
› Encounter for peritoneal equilibration test

Z51Encounter for other aftercare and medical care
Code Also: condition requiring care
Excludes 1: follow-up examination after treatment (Z08-Z09)

Z51.0Encounter for antineoplastic radiation therapy

Z51.1Encounter for antineoplastic chemotherapy and immunotherapy
Excludes 2: encounter for chemotherapy and immunotherapy for nonneoplastic condition - code to condition

Z51.11Encounter for antineoplastic chemotherapy

Z51.12Encounter for antineoplastic immunotherapy

Z51.5Encounter for palliative care

Z51.6Encounter for desensitization to allergens

Z51.8Encounter for other specified aftercare
Excludes 1: holiday relief care (Z75.5)

Z51.81Encounter for therapeutic drug level monitoring
Code Also: any long-term (current) drug therapy (Z79.-)
Excludes 1: encounter for blood-drug test for administrative or medicolegal reasons (Z02.83)

Z51.89Encounter for other specified aftercare

Z52Donors of organs and tissues
Includes: autologous and other living donors
Excludes 1: cadaveric donor - omit code
› examination of potential donor (Z00.5)

Z52.0Blood donor

Z52.00Unspecified blood donor

Z52.000Unspecified donor, whole blood

Z52.001Unspecified donor, stem cells

Z52.008Unspecified donor, other blood

Z52.01Autologous blood donor

Z52.010Autologous donor, whole blood

Z52.011Autologous donor, stem cells

Z52.018Autologous donor, other blood

Z52.09Other blood donor
› Volunteer donor

Z52.090Other blood donor, whole blood

Z52.091Other blood donor, stem cells

Z52.098Other blood donor, other blood

Z52.1Skin donor

Z52.10Skin donor, unspecified

Z52.11Skin donor, autologous

Z52.19Skin donor, other

Z52.2Bone donor

Z52.20Bone donor, unspecified

Z52.21Bone donor, autologous

Z52.29Bone donor, other

Z52.3Bone marrow donor

Z52.4Kidney donor

Z52.5Cornea donor

Z52.6Liver donor

Z52.8Donor of other specified organs or tissues

Z52.81Egg (Oocyte) donor

Z52.810Egg (Oocyte) donor under age 35, anonymous recipient
› Egg donor under age 35 NOS

Z52.811Egg (Oocyte) donor under age 35, designated recipient

Z52.812Egg (Oocyte) donor age 35 and over, anonymous recipient
› Egg donor age 35 and over NOS

Z52.813Egg (Oocyte) donor age 35 and over, designated recipient

Z52.819Egg (Oocyte) donor, unspecified

Z52.89Donor of other specified organs or tissues

Z52.9Donor of unspecified organ or tissue
› Donor NOS

Z53Persons encountering health services for specific procedures and treatment, not carried out

Z53.0Procedure and treatment not carried out because of contraindication

Z53.01Procedure and treatment not carried out due to patient smoking

Z53.09Procedure and treatment not carried out because of other contraindication

Z53.1Procedure and treatment not carried out because of patient's decision for reasons of belief and group pressure

Z53.2Procedure and treatment not carried out because of patient's decision for other and unspecified reasons

Z53.20Procedure and treatment not carried out because of patient's decision for unspecified reasons

Z53.21Procedure and treatment not carried out due to patient leaving prior to being seen by health care provider

Z53.29Procedure and treatment not carried out because of patient's decision for other reasons

Z53.3Procedure converted to open procedure

Z53.31Laparoscopic surgical procedure converted to open procedure

Z53.32Thoracoscopic surgical procedure converted to open procedure

Z53.33Arthroscopic surgical procedure converted to open procedure

Z53.39Other specified procedure converted to open procedure

Z53.8Procedure and treatment not carried out for other reasons

Z53.9Procedure and treatment not carried out, unspecified reason