Non-Billable / Non-Specific Code
ICD-10-CM Z42 is the diagnosis code for Encounter for plastic and reconstructive surgery following medical procedure or healed injury. This code falls under the section "Encounters for other specific health care" within Chapter 21 — Factors influencing health status and contact with health services (Z00-Z99). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.
The following conditions should never be coded at the same time as Z42. They are mutually exclusive:
Understanding where Z42 sits in the ICD-10-CM classification helps ensure proper coding:
No, Z42 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.
Z42 is the ICD-10-CM diagnosis code for "Encounter for plastic and reconstructive surgery following medical procedure or healed injury". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.
Z42 is located in Section Z40-Z53 — "Encounters for other specific health care" within Chapter 21 of the ICD-10-CM Tabular List.
Z42 has 2 sub-code(s) that provide more specific detail: Z42.1, Z42.8.
Use Z42 when the patients documented diagnosis matches "Encounter for plastic and reconstructive surgery following medical procedure or healed injury" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.
The ICD-10-CM code for Encounter for plastic and reconstructive surgery following medical procedure or healed injury is Z42.
No, Z42 is non-billable. Use a more specific sub-code for primary diagnosis billing.
Z42 is in Chapter 21 of the ICD-10-CM Tabular List.
Type 1 Excludes for Z42 include: encounter for cosmetic plastic surgery (Z41.1); encounter for plastic surgery for treatment of current injury - code to relevent injury.
Yes, Z42 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.