Z44.3 vs Z45
Z44.3 and Z45 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on Z44.3
encounter for adjustment or removal of breast implant (Z45.81-)
Z44.3
Encounter for fitting and adjustment of external breast prosthesis
Not billable
- Chapter 21
- Factors influencing health status and contact with health services
- Section
- Z40-Z53
Indexed under
- Admission › fitting › breast prosthesis (for)
- Fitting › artificial › breast (and adjustment) (of)
- Fitting › prosthesis › breast (and adjustment) (of)
- Admission › adjustment › breast › prosthesis (for)
- Admission › adjustment › prosthesis › breast (for)
Z45
Encounter for adjustment and management of implanted device
Not billable
- Chapter 21
- Factors influencing health status and contact with health services
- Section
- Z40-Z53
Use when the record says
- removal or replacement of implanted device
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027