Z45.812: Encounter for adjustment or removal of left breast implant
Z45.812, encounter for adjustment or removal of left breast implant, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 6 HCPCS Level II codes, including Q2028 (Injection, sculptra, 0.5 mg), G0429 (Dermal filler injection(s) for the treatment of facial…), Q2026 (Injection, radiesse, 0.1 ml). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with Z45.812 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| Q2028 | Injection, sculptra, 0.5 mg | Special coverage instructions apply | — | 2 |
| G0429 | Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy) | Carrier judgment | — | 2 |
| Q2026 | Injection, radiesse, 0.1 ml | Special coverage instructions apply | — | 2 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 1 |
Medicare policy articles listing Z45.812
- A59299: Billing and Coding: Cosmetic and Reconstructive Surgery (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33428, L35090, L38914, L39051
- A58774: Billing and Coding: Cosmetic and Reconstructive Surgery (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33428, L35090, L38914, L39051
- A53064: Billing and Coding: Outpatient Occupational Therapy (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34427
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Frequently asked questions
Does Medicare cover Z45.812 (Encounter for adjustment or removal of left breast implant)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list Z45.812 as a covered diagnosis for 6 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 Z45.812?
The Level II codes from the policies most specific to this diagnosis are Q2028 (Injection, sculptra, 0.5 mg, 2 articles); G0429 (Dermal filler injection(s) for the treatment of facial…, 2 articles); Q2026 (Injection, radiesse, 0.1 ml, 2 articles); G0283 (Electrical stimulation (unattended), to one or more areas…, 1 article); G0281 (Electrical stimulation, (unattended), to one or more…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list Z45.812?
A59299 (Billing and Coding: Cosmetic and Reconstructive Surgery); A58774 (Billing and Coding: Cosmetic and Reconstructive Surgery); A53064 (Billing and Coding: Outpatient Occupational Therapy).
What is ICD-10-CM code Z45.812?
Z45.812 is the ICD-10-CM code for encounter for adjustment or removal of left breast implant, in category Z45 (Encounter for adjustment and management of implanted device), chapter 22: Factors influencing health status and contact with health services.
Next steps
- Run a reimbursement report for a device billed under Q2028
- Watch Q2028 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q2028
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 22: Factors influencing health status and contact with health services · All diagnoses · HCPCS lookup