4) Vaginal Pap test (Z12. 72)
Group 1CodeDescriptionZ11.51*Encounter for screening for human papillomavirus (HPV)
4: Special screening examination for neoplasm of cervix.
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. However, coders are coming across many routine mammogram orders that use Z12.
88175. Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thinlayer preparation; screening by automated system, under physician supervision n/a as on clinical lab fee schedule n/a n/a n/a n/a n/a 5,467 Location-guided screening with review/rescreen.
ICD-10 Code for High risk human papillomavirus (HPV) DNA test positive from female genital organs- R87. 81- Codify by AAPC.
Z12. 11: Encounter for screening for malignant neoplasm of the colon.
Z00.00ICD-10 Code for Encounter for general adult medical examination without abnormal findings- Z00. 00- Codify by AAPC.
Z12.11. Encounter for screening for malignant neoplasm of colon.
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.
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 .
For claims for screening for syphilis in men at increased risk 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.
0XXA: Fall from non-moving wheelchair, initial encounter.
C53.9 is a billable diagnosis code used to specify a medical diagnosis of malignant neoplasm of cervix uteri, unspecified. The code C53.9 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
Free, official coding info for 2022 ICD-10-CM C53.0 - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more.
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as C53.A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
It is incorrect to report these screening services with Current Procedural Terminology (CPT®) code 87624 [Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types].
Please refer to NCD 210.2.1 for complete information on screening for cervical cancer with Human Papillomavirus (HPV).
CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Title XVIII of the Social Security Act, Section 1833 (e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period..
It has come to our attention that services submitted for screening for cervical cancer with Human Papillomavirus (HPV) Testing have been reported incorrectly. This Billing and Coding Article provides billing and coding guidance for these services. Coding Guidance
It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim (s) submitted. The following ICD-10-CM code supports medical necessity and provides coverage for HCPCS code: G0476
All those not listed under the “ICD-10 Codes that Support Medical Necessity” section of this article.
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.
Z12.11 is a valid billable ICD-10 diagnosis code for Encounter for screening for malignant neoplasm of colon . It is found in the 2021 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2020 - Sep 30, 2021 .
DO NOT include the decimal point when electronically filing claims as it may be rejected. Some clearinghouses may remove it for you but to avoid having a rejected claim due to an invalid ICD-10 code, do not include the decimal point when submitting claims electronically. See also:
CMS will cover screening for cervical cancer with HPV testing once every 5 years as a preventive service benefit under Medicare for asymptotic patients age 30 to 65 years old, with a Pap smear.
Beginning January 1, 2017, G0476 will be priced and paid according to the Clinical Laboratory Fee Schedule. As cervical cancer screening is a preventive service, no coinsurance or deductible applies.
The 2022 edition of ICD-10-CM C53.9 became effective on October 1, 2021.
A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere.