2020 ICD-10-CM Diagnosis Code Z45.81

Encounter for adjustment or removal of breast implant

    2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
  • Z45.81 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
  • The 2020 edition of ICD-10-CM Z45.81 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of Z45.81 - other international versions of ICD-10 Z45.81 may differ.
Applicable To
  • Encounter for elective implant exchange (different material) (different size)
  • Encounter removal of tissue expander with or without synchronous insertion of permanent implant
Type 1 Excludes
Type 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as Z45.81. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • complications of breast implant (
    ICD-10-CM Diagnosis Code T85.4

    Mechanical complication of breast prosthesis and implant

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    T85.4-
    )
  • encounter for initial breast implant insertion for cosmetic breast augmentation (
    ICD-10-CM Diagnosis Code Z41.1

    Encounter for cosmetic surgery

      2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
    Applicable To
    • Encounter for cosmetic breast implant
    • Encounter for cosmetic procedure
    Type 1 Excludes
    • encounter for plastic and reconstructive surgery following medical procedure or healed injury (Z42.-)
    • encounter for post-mastectomy breast implantation (Z42.1)
    Z41.1
    )
  • encounter for breast reconstruction following mastectomy (
    ICD-10-CM Diagnosis Code Z42.1

    Encounter for breast reconstruction following mastectomy

      2016 2017 2018 2019 2020 Billable/Specific Code Adult Dx (15-124 years) POA Exempt
    Type 1 Excludes
    • deformity and disproportion of reconstructed breast (N65.1-)
    Z42.1
    )
The following code(s) above Z45.81 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to Z45.81:
  • Z00-Z99
    2020 ICD-10-CM Range Z00-Z99

    Factors influencing health status and contact with health services

    Note
    • Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
    • (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
    • (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
    Factors influencing health status and contact with health services
  • Z40-Z53
    2020 ICD-10-CM Range Z40-Z53

    Encounters for other specific health care

    Applicable To
    • Categories Z40-Z53 are intended for use to indicate a reason for care. They may be used for patients who have already been treated for a disease or injury, but who are receiving aftercare or prophylactic care, or care to consolidate the treatment, or to deal with a residual state
    Type 2 Excludes
    • follow-up examination for medical surveillance after treatment (Z08-Z09)
    Encounters for other specific health care
  • Z45
    ICD-10-CM Diagnosis Code Z45

    Encounter for adjustment and management of implanted device

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Includes
    • removal or replacement of implanted device
    Type 1 Excludes
    • malfunction or other complications of device - see Alphabetical Index
    Type 2 Excludes
    • encounter for fitting and adjustment of non-implanted device (Z46.-)
    Encounter for adjustment and management of implanted device
Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
Code annotations containing back-references to Z45.81:
  • Type 1 Excludes: Z44.3
    ICD-10-CM Diagnosis Code Z44.3

    Encounter for fitting and adjustment of external breast prosthesis

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Type 1 Excludes
    • complications of breast implant (T85.4-)
    • encounter for adjustment or removal of breast implant (Z45.81-)
    • encounter for initial breast implant insertion for cosmetic breast augmentation (Z41.1)
    • encounter for breast reconstruction following mastectomy (Z42.1)

Diagnosis Index entries containing back-references to Z45.81:
  • Admission (for) - see also Encounter (for)
  • Encounter (with health service) (for) Z76.89
    ICD-10-CM Diagnosis Code Z76.89

    Persons encountering health services in other specified circumstances

      2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
    Applicable To
    • Persons encountering health services NOS
  • Removal (from) (of)
    • breast implant Z45.81

ICD-10-CM Codes Adjacent To Z45.81
Z45.31 Encounter for adjustment and management of implanted visual substitution device
Z45.32 Encounter for adjustment and management of implanted hearing device
Z45.320 Encounter for adjustment and management of bone conduction device
Z45.321 Encounter for adjustment and management of cochlear device
Z45.328 Encounter for adjustment and management of other implanted hearing device
Z45.4 Encounter for adjustment and management of implanted nervous system device
Z45.41 Encounter for adjustment and management of cerebrospinal fluid drainage device
Z45.42 Encounter for adjustment and management of neurostimulator
Z45.49 Encounter for adjustment and management of other implanted nervous system device
Z45.8 Encounter for adjustment and management of other implanted devices
Z45.81 Encounter for adjustment or removal of breast implant
Z45.811 Encounter for adjustment or removal of right breast implant
Z45.812 Encounter for adjustment or removal of left breast implant
Z45.819 Encounter for adjustment or removal of unspecified breast implant
Z45.82 Encounter for adjustment or removal of myringotomy device (stent) (tube)
Z45.89 Encounter for adjustment and management of other implanted devices
Z45.9 Encounter for adjustment and management of unspecified implanted device
Z46 Encounter for fitting and adjustment of other devices
Z46.0 Encounter for fitting and adjustment of spectacles and contact lenses
Z46.1 Encounter for fitting and adjustment of hearing aid
Z46.2 Encounter for fitting and adjustment of other devices related to nervous system and special senses

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.