Cosmetic and Reconstructive Surgery
J15 · Effective May 28, 2023
16 active Medicare policies list Z42.1, and 4 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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J15 · Effective May 28, 2023
J9 · Effective Jul 11, 2021
JH · Effective Oct 1, 2015
JL · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J5 · Effective Nov 14, 2021
J8 · Effective Nov 14, 2021
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
4 policies from 2 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of Z42.1 |
|---|---|---|
| Breast Reconstructive Surgery | Apr 7, 2023 | Covered |
| Thermography | Mar 15, 2023 | Covered |
| Policy | Effective | Status of Z42.1 |
|---|---|---|
| Breast Procedures; including Reconstructive Surgery, Implants and Other Breast Procedures | Jul 1, 2026 | Covered |
| Cosmetic and Reconstructive Services of the Trunk, Groin, and Extremities | Oct 1, 2026 | Covered |
JL · Effective Nov 17, 2025
National · Effective Jan 1, 2026
J9 · Effective Nov 17, 2025
J5 · Effective Jun 25, 2026
National · Effective Nov 27, 2025
National · Effective Oct 16, 2025