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    v1.0.28
    OpenPayerBilling CodesEncounters for other specific health careICD-10-CM z42-plastic-and-reconstructive-surgery-after-injury
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    ICD-10-CM Code For Encounter For Plastic And Reconstructive Surgery Following Medical Procedure Or Healed Injury: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group Z42 includes encounters for plastic and reconstructive surgery performed following a prior medical procedure or healed injury, covering procedures to repair defects, restore form, or improve function. These ICD-10-CM diagnosis codes are used to document postoperative or post-injury reconstructive encounters, capturing the clinical context and anatomic focus of the surgical repair. Accurate coding within the ICD-10-CM Z42 group supports proper claim adjudication and complete clinical documentation for reconstructive care.

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    ICD-10-CM Z42: Encounter for plastic and reconstructive surgery following medical procedure or healed injury Overview

    The ICD-10-CM Z42 code group represents encounters for plastic and reconstructive surgery performed after a prior medical procedure or healed injury, addressing restoration of form and function. These codes apply to procedures targeting integumentary, musculoskeletal, and other affected anatomic sites to correct defects, deformities, or residual functional impairment. Accurate coding supports correct claim processing and reflects the clinical rationale for reconstructive services.

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    When to Use

    Use a code from this group when a patient presents for plastic or reconstructive surgery that is explicitly related to a healed injury or prior medical procedure. These codes apply to encounters where the primary reason for the visit is restorative or reconstructive surgery rather than initial trauma management.

    ICD-10-CM Codes

    2 rows

    ICD-10-CM CodeDescription
    Z42.1Encounter for breast reconstruction following mastectomy
    Z42.8Encounter for other plastic and reconstructive surgery following medical procedure or healed injury

    DRG Codes

    2 rows

    DRG CodeDescription
    606Minor Skin Disorders with MCC
    607Minor Skin Disorders without MCC

    Typical Clinical Scenarios

    • A middle-aged woman presents to outpatient plastic surgery clinic for evaluation and planning of elective breast reconstruction two years after a mastectomy for breast cancer. She seeks staged reconstructive procedures to restore contour and symmetry after her cancer treatment has healed; the encounter is for planning and performing reconstructive surgery following a prior medical procedure, so a code from this group is assigned. Typical codes: Z42.1
    • An elderly man is seen in a clinic for revision surgery to correct scar contracture and poor wound healing at the site of a previously repaired traumatic facial laceration that is now fully healed but causing functional impairment. He is scheduled for reconstructive scar revision to improve mobility and appearance after the original injury has healed; the visit is coded from this group reflecting reconstructive care following a healed injury. Typical codes: Z42.8
    • A young adult who previously underwent gastric bypass presents for outpatient removal of excess abdominal skin (body-contouring) after substantial weight loss, with no active surgical complications but desire for functional and aesthetic restoration. The encounter documents planning and performance of reconstructive/esthetic surgery related to a prior medical intervention and healed condition, so a code in this group is used. Typical codes: Z42.8

    Related Codes

    Z40-ENCOUNTER-FOR-PROPHYLACTIC-SURGERY

    ICD-10-CM Code For Encounter For Prophylactic Surgery: Group Overview

    Z41-ENCOUNTER-FOR-PROCEDURES

    ICD-10-CM Code For Encounter For Procedures For Purposes Other Than Remedying Health State: Group Overview

    Z43-ENCOUNTER-FOR-ARTIFICIAL-OPENINGS

    ICD-10-CM Code For Encounter For Attention To Artificial Openings: Group Overview

    Z44-ENCOUNTER-FOR-EXTERNAL-PROSTHESIS

    ICD-10-CM Code For Encounter For Fitting And Adjustment Of External Prosthetic Device: Group Overview

    Z45-ENCOUNTER-FOR-IMPLANTED-DEVICE

    ICD-10-CM Code For Encounter For Adjustment And Management Of Implanted Device: Group Overview

    Z46-FITTING-AND-ADJUSTMENT-OF-DEVICES

    ICD-10-CM Code For Encounter For Fitting And Adjustment Of Other Devices: Group Overview

    Z47-ORTHOPEDIC-AFTERCARE

    ICD-10-CM Code For Orthopedic Aftercare: Group Overview

    Z48-OTHER-POSTPROCEDURAL-AFTERCARE

    ICD-10-CM Code For Encounter For Other Postprocedural Aftercare: Group Overview

    Z49-ENCOUNTER-FOR-RENAL-DIALYSIS

    ICD-10-CM Code For Encounter For Care Involving Renal Dialysis: Group Overview

    Z51-ENCOUNTER-FOR-OTHER-AFTERCARE

    ICD-10-CM Code For Encounter For Other Aftercare And Medical Care: Group Overview

    Showing 1–10 of 12

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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