ICD-10 · PDGM grouping
Z40 Encounter for prophylactic surgery
All 9 codes in the Z40 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
9
Can lead a claim
0
Cannot lead a claim
9
What CMS assigns to Z40
None of the 9 codes is assigned a clinical group. None of the 9 is assigned a comorbidity subgroup. None can lead a claim.
Every code in Z40
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| Z40.0 Encounter for prophylactic surgery for risk factors related to malignant neoplasms | ||||
| Z40.00 | Encounter for prophylactic removal of unspecified organ | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z40.01 | Encounter for prophylactic removal of breast | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z40.02 | Encounter for prophylactic removal of ovary(s) | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z40.03 | Encounter for prophylactic removal of fallopian tube(s) | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z40.09 | Encounter for prophylactic removal of other organ | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z40.8 Encounter for other prophylactic surgery | ||||
| Z40.81 | Encounter for prophylactic surgery for removal of ovary(s) for persons without known genetic/familial risk factorsCMS: Enc for proph surg for remov ovary(s) w/o gen/fam risk fctrs | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z40.82 | Encounter for prophylactic surgery for removal of fallopian tube(s) for persons without known genetic/familial risk factorsCMS: Enc for proph surg for remov fallop(s) w/o gen/fam risk fctr | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z40.89 | Encounter for other prophylactic surgery | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| Z40.9 | Encounter for prophylactic surgery, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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