ICD-10 · PDGM grouping
Z40-Z53 — Encounters for other specific health care
Every ICD-10-CM code in this range and the PDGM clinical group CMS assigns to it, read from the CMS grouper crosswalk v07.2.26.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in range
164
No clinical group
121
A period cannot be grouped from these.
Barred as primary
5
CMS rejects these in the primary position.
Where these codes group
20 of the 164 codes in Z40-Z53 group to MMTA - Surgical Aftercare, but the range is not uniform — it spreads across 5 clinical groups. A further 121 are assigned no clinical group at all, which means a 30-day period cannot be grouped from them.
Code families in Z40-Z53
One page per three-character family: every code in it, whether it can lead a claim, its clinical group and comorbidity subgroup.
- Z40Encounter for prophylactic surgery9 codes
- Z41Encounter for procedures for purposes other than remedying health state5 codes
- Z42Encounter for plastic and reconstructive surgery following medical procedure or healed injury2 codes
- Z43Encounter for attention to artificial openings10 codes
- Z44Encounter for fitting and adjustment of external prosthetic device26 codes
- Z45Encounter for adjustment and management of implanted device19 codes
- Z46Encounter for fitting and adjustment of other devices12 codes
- Z47Orthopedic aftercare8 codes
- Z48Encounter for other postprocedural aftercare23 codes
- Z49Encounter for care involving renal dialysis4 codes
- Z51Encounter for other aftercare and medical care8 codes
- Z52Donors of organs and tissues26 codes
- Z53Persons encountering health services for specific procedures and treatment, not carried out12 codes
Every code in Z40-Z53
Descriptions are CMS’s own, abbreviated as CMS abbreviates them.
| Code | Description | Clinical group | Primary position |
|---|---|---|---|
| Z4000 | Encounter for prophylactic removal of unspecified organ | None | Cannot lead a claim |
| Z4001 | Encounter for prophylactic removal of breast | None | Cannot lead a claim |
| Z4002 | Encounter for prophylactic removal of ovary(s) | None | Cannot lead a claim |
| Z4003 | Encounter for prophylactic removal of fallopian tube(s) | None | Cannot lead a claim |
| Z4009 | Encounter for prophylactic removal of other organ | None | Cannot lead a claim |
| Z4081 | Enc for proph surg for remov ovary(s) w/o gen/fam risk fctrs | None | Cannot lead a claim |
| Z4082 | Enc for proph surg for remov fallop(s) w/o gen/fam risk fctr | None | Cannot lead a claim |
| Z4089 | Encounter for other prophylactic surgery | None | Cannot lead a claim |
| Z409 | Encounter for prophylactic surgery, unspecified | None | Cannot lead a claim |
| Z411 | Encounter for cosmetic surgery | None | Cannot lead a claim |
| Z412 | Encounter for routine and ritual male circumcision | None | Cannot lead a claim |
| Z413 | Encounter for ear piercing | None | Cannot lead a claim |
| Z418 | Encntr for oth proc for purpose oth than remedy health state | None | Cannot lead a claim |
| Z419 | Encntr for proc for purpose oth than remedy hlth state, unsp | None | Cannot lead a claim |
| Z421 | Encounter for breast reconstruction following mastectomy | None | Cannot lead a claim |
| Z428 | Encntr for oth plast/recnst surg fol med proc or heal injury | None | Cannot lead a claim |
| Z430 | Encounter for attention to tracheostomy | D | Can lead a claim |
| Z431 | Encounter for attention to gastrostomy | D | Can lead a claim |
| Z432 | Encounter for attention to ileostomy | D | Can lead a claim |
| Z433 | Encounter for attention to colostomy | D | Can lead a claim |
| Z434 | Encounter for attn to oth artif openings of digestive tract | D | Can lead a claim |
| Z435 | Encounter for attention to cystostomy | D | Can lead a claim |
| Z436 | Encounter for attn to oth artif openings of urinary tract | D | Can lead a claim |
| Z437 | Encounter for attention to artificial vagina | D | Can lead a claim |
| Z438 | Encounter for attention to other artificial openings | D | Can lead a claim |
| Z439 | Encounter for attention to unspecified artificial opening | None | Cannot lead a claim |
| Z44001 | Encounter for fit/adjst of unsp right artificial arm | None | Cannot lead a claim |
| Z44002 | Encounter for fit/adjst of unsp left artificial arm | None | Cannot lead a claim |
| Z44009 | Encounter for fit/adjst of unsp artificial arm, unsp arm | None | Cannot lead a claim |
| Z44011 | Encounter for fit/adjst of complete right artificial arm | None | Cannot lead a claim |
| Z44012 | Encounter for fit/adjst of complete left artificial arm | None | Cannot lead a claim |
| Z44019 | Encounter for fit/adjst of complete artificial arm, unsp arm | None | Cannot lead a claim |
| Z44021 | Encounter for fit/adjst of partial artificial right arm | None | Cannot lead a claim |
| Z44022 | Encounter for fit/adjst of partial artificial left arm | None | Cannot lead a claim |
| Z44029 | Encounter for fit/adjst of partial artificial arm, unsp arm | None | Cannot lead a claim |
| Z44101 | Encounter for fit/adjst of unsp right artificial leg | None | Cannot lead a claim |
| Z44102 | Encounter for fit/adjst of unsp left artificial leg | None | Cannot lead a claim |
| Z44109 | Encounter for fit/adjst of unsp artificial leg, unsp leg | None | Cannot lead a claim |
| Z44111 | Encounter for fit/adjst of complete right artificial leg | None | Cannot lead a claim |
| Z44112 | Encounter for fit/adjst of complete left artificial leg | None | Cannot lead a claim |
| Z44119 | Encounter for fit/adjst of complete artificial leg, unsp leg | None | Cannot lead a claim |
| Z44121 | Encounter for fit/adjst of partial artificial right leg | None | Cannot lead a claim |
| Z44122 | Encounter for fit/adjst of partial artificial left leg | None | Cannot lead a claim |
| Z44129 | Encounter for fit/adjst of partial artificial leg, unsp leg | None | Cannot lead a claim |
| Z4420 | Encounter for fitting and adjustment of artificial eye, unsp | None | Cannot lead a claim |
| Z4421 | Encounter for fitting and adjustment of artificial right eye | None | Cannot lead a claim |
| Z4422 | Encounter for fitting and adjustment of artificial left eye | None | Cannot lead a claim |
| Z4430 | Encntr for fit/adjst of external breast prosth, unsp breast | None | Cannot lead a claim |
| Z4431 | Encounter for fit/adjst of external right breast prosthesis | None | Cannot lead a claim |
| Z4432 | Encounter for fit/adjst of external left breast prosthesis | None | Cannot lead a claim |
| Z448 | Encounter for fit/adjst of external prosthetic devices | None | Cannot lead a claim |
| Z449 | Encounter for fit/adjst of unsp external prosthetic device | None | Cannot lead a claim |
| Z45010 | Encntr for checking and test of card pacemaker pulse gnrtr | None | Cannot lead a claim |
| Z45018 | Encounter for adjust and mgmt oth prt cardiac pacemaker | None | Cannot lead a claim |
| Z4502 | Encntr for adjust and mgmt of automatic implntbl card defib | None | Cannot lead a claim |
| Z4509 | Encounter for adjustment and management of cardiac device | None | Cannot lead a claim |
| Z451 | Encounter for adjustment and management of infusion pump | None | Cannot lead a claim |
| Z452 | Encounter for adjustment and management of VAD | D | Can lead a claim |
| Z4531 | Encntr for adjust and mgmt of implnt visual substitution dev | None | Cannot lead a claim |
| Z45320 | Encounter for adjust and mgmt of bone conduction device | None | Cannot lead a claim |
| Z45321 | Encounter for adjustment and management of cochlear device | None | Cannot lead a claim |
| Z45328 | Encounter for adjust and management of implanted hear dev | None | Cannot lead a claim |
| Z4541 | Encounter for adjustment and management of CSF drain dev | None | Cannot lead a claim |
| Z4542 | Encounter for adjustment and management of neurostimulator | None | Cannot lead a claim |
| Z4549 | Encntr for adjust and mgmt of implanted nervous sys device | None | Cannot lead a claim |
| Z45811 | Encounter for adjustment or removal of right breast implant | None | Cannot lead a claim |
| Z45812 | Encounter for adjustment or removal of left breast implant | None | Cannot lead a claim |
| Z45819 | Encounter for adjustment or removal of unsp breast implant | None | Cannot lead a claim |
| Z4582 | Encntr for adjust or removal of myringotomy device (tube) | None | Cannot lead a claim |
| Z4589 | Encounter for adjustment and management of implanted devices | None | Cannot lead a claim |
| Z459 | Encounter for adjust and management of unsp implanted device | None | Cannot lead a claim |
| Z460 | Encounter for fit/adjst of spectacles and contact lenses | None | Cannot lead a claim |
| Z461 | Encounter for fitting and adjustment of hearing aid | None | Cannot lead a claim |
| Z462 | Encntr for fit/adjst of dev rel to nrv sys and specl senses | None | Cannot lead a claim |
| Z463 | Encounter for fit/adjst of dental prosthetic device | None | Cannot lead a claim |
| Z464 | Encounter for fitting and adjustment of orthodontic device | None | Cannot lead a claim |
| Z4651 | Encounter for fitting and adjustment of gastric lap band | None | Cannot lead a claim |
| Z4659 | Encounter for fit/adjst of GI appliance and device | None | Cannot lead a claim |
| Z466 | Encounter for fitting and adjustment of urinary device | D | Can lead a claim |
| Z4681 | Encounter for fitting and adjustment of insulin pump | None | Cannot lead a claim |
| Z4682 | Encounter for fit/adjst of non-vascular catheter | None | Cannot lead a claim |
| Z4689 | Encounter for fitting and adjustment of oth devices | None | Cannot lead a claim |
| Z469 | Encounter for fitting and adjustment of unspecified device | None | Cannot lead a claim |
| Z471 | Aftercare following joint replacement surgery | E | Can lead a claim |
| Z472 | Encounter for removal of internal fixation device | None | Cannot lead a claim |
| Z4731 | Aftercare following explantation of shoulder jt prosthesis | E | Can lead a claim |
| Z4732 | Aftercare following explantation of hip joint prosthesis | E | Can lead a claim |
| Z4733 | Aftercare following explantation of knee joint prosthesis | E | Can lead a claim |
| Z4781 | Encounter for orthopedic aftercare following surgical amp | E | Can lead a claim |
| Z4782 | Encounter for orth aftercare following scoliosis surgery | E | Can lead a claim |
| Z4789 | Encounter for other orthopedic aftercare | E | Can lead a claim |
| Z4800 | Encounter for change or removal of nonsurg wound dressing | C | Can lead a claim |
| Z4801 | Encounter for change or removal of surgical wound dressing | C | Can lead a claim |
| Z4802 | Encounter for removal of sutures | G | Can lead a claim |
| Z4803 | Encounter for change or removal of drains | G | Can lead a claim |
| Z481 | Encounter for planned postprocedural wound closure | None | Cannot lead a claim |
| Z4821 | Encounter for aftercare following heart transplant | G | Can lead a claim |
| Z4822 | Encounter for aftercare following kidney transplant | G | Can lead a claim |
| Z4823 | Encounter for aftercare following liver transplant | G | Can lead a claim |
| Z4824 | Encounter for aftercare following lung transplant | G | Can lead a claim |
| Z48280 | Encounter for aftercare following heart-lung transplant | G | Can lead a claim |
| Z48288 | Encounter for aftercare following multiple organ transplant | G | Can lead a claim |
| Z48290 | Encounter for aftercare following bone marrow transplant | G | Can lead a claim |
| Z48298 | Encounter for aftercare following other organ transplant | G | Can lead a claim |
| Z483 | Aftercare following surgery for neoplasm | G | Can lead a claim |
| Z48810 | Encntr for surgical aftcr fol surgery on the sense organs | G | Can lead a claim |
| Z48811 | Encntr for surgical aftcr fol surgery on the nervous sys | G | Can lead a claim |
| Z48812 | Encntr for surgical aftcr following surgery on the circ sys | G | Can lead a claim |
| Z48813 | Encntr for surgical aftcr following surgery on the resp sys | G | Can lead a claim |
| Z48814 | Encntr for surg aftcr fol surg on the teeth or oral cavity | G | Can lead a claim |
| Z48815 | Encntr for surgical aftcr following surgery on the dgstv sys | G | Can lead a claim |
| Z48816 | Encounter for surgical aftcr following surgery on the GU sys | G | Can lead a claim |
| Z48817 | Encntr for surgical aftcr fol surgery on the skin, subcu | G | Can lead a claim |
| Z4889 | Encounter for other specified surgical aftercare | G | Can lead a claim |
| Z4901 | Encounter for fit/adjst of extracorporeal dialysis catheter | None | Cannot lead a claim |
| Z4902 | Encounter for fit/adjst of peritoneal dialysis catheter | None | Cannot lead a claim |
| Z4931 | Encounter for adequacy testing for hemodialysis | None | Cannot lead a claim |
| Z4932 | Encounter for adequacy testing for peritoneal dialysis | None | Cannot lead a claim |
| Z510 | Encounter for antineoplastic radiation therapy | None | Cannot lead a claim |
| Z5111 | Encounter for antineoplastic chemotherapy | D | Can lead a claim |
| Z5112 | Encounter for antineoplastic immunotherapy | D | Can lead a claim |
| Z515 | Encounter for palliative care | A | Can lead a claim |
| Z516 | Encounter for desensitization to allergens | None | Cannot lead a claim |
| Z5181 | Encounter for therapeutic drug level monitoring | None | Cannot lead a claim |
| Z5189 | Encounter for other specified aftercare | None | Cannot lead a claim |
| Z51A | Encounter for sepsis aftercare | None | Cannot lead a claim |
| Z52000 | Unspecified donor, whole blood | None | Cannot lead a claim |
| Z52001 | Unspecified donor, stem cells | None | Cannot lead a claim |
| Z52008 | Unspecified donor, other blood | None | Cannot lead a claim |
| Z52010 | Autologous donor, whole blood | None | Cannot lead a claim |
| Z52011 | Autologous donor, stem cells | None | Cannot lead a claim |
| Z52018 | Autologous donor, other blood | None | Cannot lead a claim |
| Z52090 | Other blood donor, whole blood | None | Cannot lead a claim |
| Z52091 | Other blood donor, stem cells | None | Cannot lead a claim |
| Z52098 | Other blood donor, other blood | None | Cannot lead a claim |
| Z5210 | Skin donor, unspecified | None | Cannot lead a claim |
| Z5211 | Skin donor, autologous | None | Cannot lead a claim |
| Z5219 | Skin donor, other | None | Cannot lead a claim |
| Z5220 | Bone donor, unspecified | None | Cannot lead a claim |
| Z5221 | Bone donor, autologous | None | Cannot lead a claim |
| Z5229 | Bone donor, other | None | Cannot lead a claim |
| Z523 | Bone marrow donor | None | Cannot lead a claim |
| Z524 | Kidney donor | None | Cannot lead a claim |
| Z525 | Cornea donor | None | Cannot lead a claim |
| Z526 | Liver donor | None | Cannot lead a claim |
| Z52810 | Egg (Oocyte) donor under age 35, anonymous recipient | None | Cannot lead a claim |
| Z52811 | Egg (Oocyte) donor under age 35, designated recipient | None | Cannot lead a claim |
| Z52812 | Egg (Oocyte) donor age 35 and over, anonymous recipient | None | Cannot lead a claim |
| Z52813 | Egg (Oocyte) donor age 35 and over, designated recipient | None | Cannot lead a claim |
| Z52819 | Egg (Oocyte) donor, unspecified | None | Cannot lead a claim |
| Z5289 | Donor of other specified organs or tissues | None | Cannot lead a claim |
| Z529 | Donor of unspecified organ or tissue | None | Cannot lead a claim |
| Z5301 | Proc/trtmt not carried out due to patient smoking | None | Cannot lead a claim |
| Z5309 | Proc/trtmt not carried out because of contraindication | None | Cannot lead a claim |
| Z531 | Proc/trtmt not crd out bec pt belief and group pressure | None | Cannot lead a claim |
| Z5320 | Proc/trtmt not crd out bec pt decision for unsp reasons | None | Cannot lead a claim |
| Z5321 | Proc/trtmt not crd out d/t pt lv bef seen by hlth care prov | None | Cannot lead a claim |
| Z5329 | Proc/trtmt not crd out bec pt decision for oth reasons | None | Cannot lead a claim |
| Z5331 | Laparoscopic surgical procedure converted to open procedure | None | Cannot lead a claim |
| Z5332 | Thoracoscopic surgical procedure converted to open procedure | None | Cannot lead a claim |
| Z5333 | Arthroscopic surgical procedure converted to open procedure | None | Cannot lead a claim |
| Z5339 | Other specified procedure converted to open procedure | None | Cannot lead a claim |
| Z538 | Procedure and treatment not carried out for other reasons | None | Cannot lead a claim |
| Z539 | Procedure and treatment not carried out, unspecified reason | None | Cannot lead a claim |
Source: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01. 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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