ICDcodes.org
FY2027

Z45.81Encounter for adjustment or removal of breast implant

Not billable

Is Z45.81 billable?

No — Z45.81 is a non-billable header code. Z45.81 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 3 billable codes beneath Z45.81.

Z45.81 at a glance

CodeZ45.81
DescriptionEncounter for adjustment or removal of breast implant
BillableNo — header code
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

How is Z45.81 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to Z45.81. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Encounterbreast implant exchange (with health service) (for)
  • Removalbreast implant (from) (of)
  • Encounteradjustment and managementbreast implant (with health service) (for)
  • Encounterremovalbreast implant (with health service) (for)
  • Admissionadjustmentbreastimplant (for)
  • Encounterremovalbreast implanttissue expander (with health service) (for)

Excludes1 — never code together

The conditions below can never be reported together with Z45.81 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • complications of breast implant (T85.4-)
  • encounter for initial breast implant insertion for cosmetic breast augmentation (Z41.1)
  • encounter for breast reconstruction following mastectomy (Z42.1)

Inclusion terms

Alternative wording in documentation that is classified to Z45.81.

  • Encounter for elective implant exchange (different material) (different size)
  • Encounter for removal of tissue expander with or without synchronous insertion of permanent implant

Excludes1 — never code together — inherited from Z45

The conditions below can never be reported together with Z45.81 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • malfunction or other complications of device - see Alphabetical Index

Excludes2 — not included here — inherited from Z40-Z53

The conditions below are not part of Z45.81, but a patient may have both at the same time. When documentation supports it, Z45.81 and the excluded code may both be reported.

  • follow-up examination for medical surveillance after treatment (Z08-Z09)

Excludes2 — not included here — inherited from Z45

The conditions below are not part of Z45.81, but a patient may have both at the same time. When documentation supports it, Z45.81 and the excluded code may both be reported.

  • encounter for fitting and adjustment of non-implanted device (Z46.-)

What codes fall under Z45.81? (3)

How long has Z45.81 existed?

Z45.81 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

Which conditions are coded to Z45.81?

What other codes are in the Z45.8 family? (2)