Z41.1 vs Z42
Z41.1 (Encounter for cosmetic surgery) compared with Z42 (Encounter for plastic and reconstructive surgery following medical procedure or healed injury), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. Z41.1 carries an Excludes1 note covering Z42: “encounter for plastic and reconstructive surgery following medical procedure or healed injury (Z42.-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. Z42 carries an Excludes1 note covering Z41.1: “encounter for cosmetic plastic surgery (Z41.1)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| Z41.1Encounter for cosmetic surgery | Z42Encounter for plastic and reconstructive surgery following medical procedure or healed injury | |
|---|---|---|
| Billing status | Billable | Non-billable header |
| Classification | Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99) | Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99) |
| Definition | Encounter for cosmetic surgery is a billable ICD-10-CM diagnosis code (Z41.1). | Encounter for plastic and reconstructive surgery following medical procedure or healed injury is a non-billable ICD-10-CM category code (Z42). |
| Includes | Encounter for cosmetic breast implant Encounter for cosmetic procedure | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources