11 (Encounter for screening for malignant neoplasm of colon) as the first-listed diagnosis code; this is the reason for the service or encounter. Use of Z12. 11 in the first diagnosis position is essential to ensure the member's screening colonoscopy/sigmoidoscopy no-cost-share benefits are accessed.
ICD-10 Code for Encounter for screening for malignant neoplasm of colon- Z12. 11- Codify by AAPC.
A family of CPT codes applies to colonoscopy. For example, code 45378 applies to a colonoscopy in which no polyp is detected, while codes 45380-45385 apply to colonoscopy that involves an intervention (e.g., 45385 is the code for colonoscopy with polypectomy.)
If the patient presents for a screening colonoscopy and a polyp or any other lesion/diagnosis is found, the primary diagnosis is still going to be Z12. 11, Encounter for screening for malignant neoplasm of colon. The coder should also report the polyp or findings as additional diagnosis codes.
To report screening colonoscopy on a patient not considered high risk for colorectal cancer, use HCPCS code G0121 and diagnosis code Z12. 11 (encounter for screening for malignant neoplasm of the colon).
G0121 – Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk.G0105 – Colorectal cancer screening; colonoscopy on individual at high risk.G0104 – Colorectal cancer screening; flexible sigmoidoscopy.
45380—Colonoscopy, with biopsy, single or multiple. Hint: The physician may use the words “biopsy forceps,” or “Jumbo forceps.” Fee amount $468.96. 45385—Colonoscopy, with removal of tumor(s), polyp(s), lesion(s) by snare technique.
CPT® Code 45380 in section: Colonoscopy, flexible, proximal to splenic flexure.
ICD-10 code K63. 5 for Polyp of colon is a medical classification as listed by WHO under the range - Diseases of the digestive system .
ICD-10 code Z12. 12 for Encounter for screening for malignant neoplasm of rectum is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
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.
A screening colonoscopy will have no out-of-pocket costs for patients (such as co-pays or deductibles). A “diagnostic” colonoscopy is a colonoscopy that is done to investigate abnormal symptoms, tests, prior conditions or family history.