Z90.11

Z90.11: Acquired absence of right breast and nipple

Billable / specific codeICD-10-CMPOA exemptright

Z90.11 is a billable, specific ICD-10-CM code for acquired absence of right breast and nipple. It is valid for submission on a claim.

Check Z90.11 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above Z90.11

A category’s note binds every code beneath it.

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

congenital absence - see Alphabetical Index

Excludes2 inherited from the categories above Z90.11

Not part of this code, but both may be coded when both are present.

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

postprocedural absence of endocrine glands (E89.-)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

Z90.11 is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52478External Breast Prostheses - Policy Article
A56658Billing and Coding: Cosmetic and Reconstructive Surgery
A58774Billing and Coding: Cosmetic and Reconstructive Surgery
A59299Billing and Coding: Cosmetic and Reconstructive Surgery

Code history

Unchanged in every release from FY2024 to FY2027.