Z12.31 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Encntr screen mammogram for malignant neoplasm of breast The 2022 edition of ICD-10-CM Z12.31 became effective on October 1, 2021.
These insights are included in the report as a major market contributor. Medical coding is the conversion of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. It includes assigning the appropriate ...
Encounter for screening for cardiovascular disorders
What is ICD-10-CM, ICD-10-PCS, CPT, and HCPCS?
Group 1CodeDescriptionZ12.31Encounter for screening mammogram for malignant neoplasm of breast
2022 ICD-10-CM Diagnosis Code R92. 8: Other abnormal and inconclusive findings on diagnostic imaging of breast.
Z12. 31 (Encounter for screening mammogram for malignant neoplasm of breast) is reported for screening mammograms while Z12. 39 (Encounter for other screening for malignant neoplasm of breast) has been established for reporting screening studies for breast cancer outside the scope of mammograms.
The proper diagnosis code to report would be Z12. 31, Encounter for screening mammogram for malignant neoplasm of breast. The Medicare deductible and co-pay/coinsurance are waived for this service.
Z12. 11: Encounter for screening for malignant neoplasm of the colon.
Z12. 39 Encounter for oth screening for malignant neoplasm of breast - ICD-10-CM Diagnosis Codes. HCPCS.
ICD-10 code Z12. 39 for Encounter for other screening for malignant neoplasm of breast is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
39 (Encounter for other screening for malignant neoplasm of breast). Z12. 39 is the correct code to use when employing any other breast cancer screening technique (besides mammogram) and is generally used with breast MRIs.
9.
The colonoscopy or sigmoidoscopy is still classified as a preventive service eligible for coverage at the no-member-cost-share benefit level. a. Submit the claim with Z12. 11 (Encounter for screening for malignant neoplasm of colon) as the first-listed diagnosis code; this is the reason for the service or encounter.
Encounter for other procreative investigation and testingICD-10 code Z31. 49 for Encounter for other procreative investigation and testing is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
For claims for screening for syphilis in pregnant women at increased risk for STIs use the following ICD-10-CM diagnosis codes: • Z11. 3 - Encounter for screening for infections with a predominantly sexual mode of transmission; • and any of: Z72.
For example, Z12. 31 (Encounter for screening mammogram for malignant neoplasm of breast) is the correct code to use when you are ordering a routine mammogram for a patient.
793.80 - Abnormal mammogram, unspecified | ICD-10-CM.
77066, Diagnostic mammography, including CAD when performed; bilateral. 77067, Screening mammography, bilateral (two-view study of each breast), including CAD when performed. In a perfect world, the new CPT codes would result in uniform coding of mammography services.
The difference is that with 2-D mammograms, images are only taken from the front and side – which may create images of overlapping breast tissue – while 3-D mammography renders images of the breast in multiple “slices” from various angles. This makes it easier to find potentially worrisome abnormalities.
Diagnostic Mammography: Diagnostic mammography includes additional x-ray views of each breast, taken from different angles and if performed digitally, may be manipulated, enlarged, or enhanced for better visualization of the abnormality found during screening mammography.
Screening Mammography: Screenings are performed on otherwise healthy individuals to look for cancer or precursors to cancer of the breasts.
Screening mammography is recommended for women age 40 and older every one to two years and younger than 40 years of age when the patient has increased risk factors for breast cancer.
In general, screening mammograms are not recommended for women under 40 years of age, in part because breast tissue tends to be more dense in younger women, making mammograms as a screening tool less effective.
CAD: Computer-Aided Detection (CAD) is a computer-based process that is used in conjunction with digital mammography to analyze mammographic images and identify suspicious areas by marking them and bringing them to the radiologist's attention.
As a screening mammogram is inherently bilateral in nature, report modifier -52 when screening mammogram is performed on a patient with a history of mastectomy where only one breast is imaged.
Report code V76.12 (Screening for malignant neoplasms, other screening mammogram) for all other screening mammography. If the patient has a personal history of breast cancer, has completed active treatment and is back to annual mammographic screening, report V76.11.
Z codes (Factors Influencing Health Status and Contact with Health Services (Z00-Z99)), found in ICD-10-CM, chapter 21, are required to describe a patient’s condition or status in four primary circumstances:
Screening is testing for disease or disease precursors in seemingly well individuals so early detection and treatment can be provided for those who test positive for the disease (e.g., a screening mammogram is intended to detect breast cancer early, so it can be treated before it becomes more serious or widespread).
The Z code indicates that a screening exam is planned. A screening code may be the first-listed code if the reason for the visit is specifically the screening exam. A screening Z code also may be used as an additional code if the screening is done during an office visit for other problems.
ICD-10-CM diagnosis codes support medical necessity by identifying the reason for the patient encounter, which may include an acute injury or illness, a chronic health condition, or signs and symptoms (e.g., pain, cough, shortness of breath, etc.) that warrants further investigation. When a patient presents for health screening services without a specific complaint, however, it’s time to call on Z codes.
Aspen I would feel you should not use a screening code if it is inherent to a yearly physical. Now if for example a patient is being seen without any real sign or symptom but their family history shows recent family Dx’d with breast cancer and patient wants to have screening done then I would apply the dx if provider is ordering a screening because there are not signs or symptoms to support this service. I would use appropriate Z code such as Z71.1 followed by family history code and then lastly the screening code.
A screening code is not necessary if the screening is inherent to a routine examination, such as Pap smear done during a routine pelvic examination. If a condition is discovered during the screening, you may assign the code for the condition as an additional diagnosis.
The rationale asks us to code only the Z12.31 . it states that R92.2 should only be coded along with the screening Z code in case of a Follow Up visit. Mr Ramesh said in above article,” If a condition is discovered during screening you may code the condition as an additional diagnosis”. Whos right?