Z40.9
Z40.9: Encounter for prophylactic surgery, unspecified
Billable / specific codeICD-10-CM
Z40.9 is a billable, specific ICD-10-CM code for encounter for prophylactic surgery, unspecified. It is valid for submission on a claim.
Check Z40.9 with the rest of the claim: free scrubberOther codes that can never be billed with Z40.9
Their own Excludes1 notes name this code, so the conflict is not listed above.
- Z29Encounter for other prophylactic measures
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
Z40.9 is named in 1 Medicare coverage policy: 0 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A56658Billing and Coding: Cosmetic and Reconstructive Surgerynot covered
Alphabetic index entries that lead here
- Prophylactic›surgery
Code history
Unchanged in every release from FY2024 to FY2027.