Is Z90.10 a billable ICD-10-CM code?

Yes. Z90.10 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z90.10 sit in the tabular list?

Factors influencing health status and contact with health services (Z00-Z99), in the block Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).

What cannot be coded together with Z90.10?

Z90.10 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Z90.10 (Z90) and apply to it just the same.

Z90.10

Z90.10 — Acquired absence of unspecified breast and nipple

Billable / specific codeICD-10-CMPOA exemptunspecified

Z90.10 is a billable, specific ICD-10-CM code for acquired absence of unspecified breast and nipple. It is valid for submission on a claim.

Excludes1 inherited from the categories above Z90.10

These are not written on Z90.10, but they bind it: a note on a category applies to every code beneath it. Billing Z90.10 with anything listed here is a denial.

Written on Z90 — Acquired absence of organs, not elsewhere classified

congenital absence - see Alphabetical Index

Excludes2 inherited from the categories above Z90.10

Also inherited, and the opposite of Excludes1: these conditions are not part of Z90.10, but a patient can have both, so you may code both.

Written on Z90 — Acquired absence of organs, not elsewhere classified

postprocedural absence of endocrine glands (E89.-)

Risk adjustment

Z90.10 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.

Medicare coverage

Z90.10 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52478External Breast Prostheses - Policy Article

Code history

Z90.10 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share Z90.1. If Z90.10 is not quite right, the correct code is usually one of these.

Questions about Z90.10

Is Z90.10 a billable ICD-10-CM code?: Yes. Z90.10 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z90.10 sit in the tabular list?: Factors influencing health status and contact with health services (Z00-Z99), in the block Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).
What cannot be coded together with Z90.10?: Z90.10 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Z90.10 (Z90) and apply to it just the same.