Z41.1
Z41.1: Encounter for cosmetic surgery
Billable / specific codeICD-10-CMPOA exempt
Z41.1 is a billable, specific ICD-10-CM code for encounter for cosmetic surgery. It is valid for submission on a claim.
Check Z41.1 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Encounter for cosmetic breast implant
- Encounter for cosmetic procedure
Other codes that can never be billed with Z41.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
Z41.1 is named in 10 Medicare coverage policies: 0 listing it as supporting medical necessity, and 10 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A54602Billing and Coding: Removal of Benign Skin Lesionsnot covered
- A56439Billing and Coding: Blepharoplastynot covered
- A56587Billing and Coding: Cosmetic and Reconstructive Surgerynot covered
- A56658Billing and Coding: Cosmetic and Reconstructive Surgerynot covered
Alphabetic index entries that lead here
- Admission›breast augmentation or reduction
- Admission›cosmetic surgery NEC
- Admission›plastic surgery, cosmetic NEC
- Encounter›breast augmentation or reduction
Code history
Unchanged in every release from FY2024 to FY2027.