Is Z42 a billable ICD-10-CM code?

No. Z42 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does Z42 sit in the tabular list?

Factors influencing health status and contact with health services (Z00-Z99), in the block Encounters for other specific health care (Z40-Z53).

What cannot be coded together with Z42?

Z42 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

Z42

Z42 — Encounter for plastic and reconstructive surgery following medical procedure or healed injury

Non-billable headerICD-10-CM

Z42 is a non-billable header ICD-10-CM code for encounter for plastic and reconstructive surgery following medical procedure or healed injury. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

encounter for cosmetic plastic surgery (Z41.1)
encounter for plastic surgery for treatment of current injury - code to relevent injury

Other codes that can never be billed with Z42

These codes carry an Excludes1 note pointing at Z42. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z42 alone.

Z41.1Encounter for cosmetic surgery
Z44.3Encounter for fitting and adjustment of external breast prosthesis
Z45.81Encounter for adjustment or removal of breast implant

Risk adjustment

Z42 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead Z42

2 child codes. Green means billable.

Questions about Z42

Is Z42 a billable ICD-10-CM code?: No. Z42 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does Z42 sit in the tabular list?: Factors influencing health status and contact with health services (Z00-Z99), in the block Encounters for other specific health care (Z40-Z53).
What cannot be coded together with Z42?: Z42 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.