Z40.0 Encounter for prophylactic surgery for risk factors related to malignant neoplasms

⚠ Non-Billable ICD-10-CM 2026
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The ICD-10-CM code for Encounter for prophylactic surgery for risk factors related to malignant neoplasms is Z40.0 (FY2026). It is a non-billable category code — select a more specific code below for claims.

Classification

Section
Z40-Z53: Encounters for other specific health care (Z40-Z53)
Category Z40
12 codes (9 billable)
FY2026 Status
Stable since FY2024
Use Additional Code
  • code to identify risk factor, such as genetic susceptibility to malignant neoplasm Z15.-

Inclusion Terms

  • Admission for prophylactic organ removal

Official Coding Guidelines

Prophylactic organ removal—principal/first-listed Z40 code

Prophylactic Organ Removal For encounters specifically for prophylactic removal of an organ (such as prophylactic removal of breasts due to a genetic susceptibility to cancer or a family history of cancer), the principal or first-listed code should be a code from subcategory Z40.0, Encounter for prophylactic surgery for risk factors related to malignant neoplasms, or subcategory Z40.8, Encounter for other prophylactic surgery. If applicable, assign additional code(s) to identify any associated risk factor (such as genetic susceptibility or family history).

— ICD-10-CM Official Guidelines for Coding and Reporting, FY2026, Section I.C.21.c.13.a
Malignancy plus prophylactic removal at another site; when not to use Z40.0

If the patient has a malignancy of one site and is having prophylactic removal at another site to prevent either a new primary malignancy or metastatic disease, a code for the malignancy should also be assigned in addition to a code from subcategory Z40.0, Encounter for prophylactic surgery for risk factors related to malignant neoplasms. A Z40.0 code should not be assigned if the patient is having organ removal for treatment of a malignancy, such as the removal of the testes for the treatment of prostate cancer.

— ICD-10-CM Official Guidelines for Coding and Reporting, FY2026, Section I.C.21.c.13.b

Source: CMS — ICD-10-CM Official Guidelines for Coding and Reporting, FY2026

References

Related Codes

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Reviewed by Prajwal Shrestha, CPC, CRC
Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) · AAPC Member ID 01997614 · About · Editorial policy · Content last reviewed: 2025-10-01

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