icd 10 code for low dose lung cancer screening

What is the diagnosis code for lung cancer screening?

Apr 28, 2020 · Encounter for screening for malignant neoplasm of respiratory organs. Z12. 2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2020 edition of ICD-10-CM Z12. Click to see full answer.

What is the ICD 10 diagnosis code for?

Oct 01, 2021 · Z12.2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Encntr screen for malignant neoplasm of respiratory organs. The 2022 edition of ICD-10-CM Z12.2 became effective on October 1, 2021.

What does ICD 10 do you use for EKG screening?

71271— Computed tomography, thorax, low dose for lung cancer screening, without contrast material (s) Medicare will deny G0296 and 71271 for claims that do not contain these ICD-10 diagnosis codes: Z87.891 for former smokers (personal history of nicotine dependence). F17.21 for current smokers (nicotine dependence).

Are Cancer Registrars ready for ICD-10?

Medicare will deny G0296 (Counseling visit to discuss need for lung cancer screening (LDCT) using low dose CT scan (service is for eligibility determination and shared decision making) and G0297 (Low dose CT scan (LDCT) for lung cancer screening) for claims that do not contain the ICD 9 CM code V15.82 (History of tobacco use) for claims with dates of service February 5, …

How many cigarettes are in a pack year?

One pack-year is the equivalent of smoking an average of 20 cigarettes—1 pack—per day for a year. Screen: If the person is aged 50 to 80 years and has a 20 pack-year or more smoking history, engage in shared decision making about screening.

What is a treating physician?

As defined in §1861 (r) of the Social Security Act (the Act), a “treating physician” is a physician, who furnishes a consultation or treats a beneficiary for a specific medical problem, and who uses the results of a diagnostic test in the management of the beneficiary’s specific medical problem.

LDCT Lung Cancer Screening - Important ICD-10-CM Coding Issue

And if the confusion surrounding what type of providers wasn’t enough, there is also a LDCT screening coding problem involving ICD-10-CM codes.

How to Use the New LDCT Lung Cancer Screening Codes

The code to use for a SDM visit is G0296 (counseling visit to discuss need for lung cancer screening [LDCT]). This is a 15 minute code with reimbursement of $69.65 in the hospital out- patient setting and $28.64 in a physician’s office. It can be billed on the same day as an E/M visit, provided medical necessity is met.

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

CMS Internet-Only Manual, Pub 100-04, Medicare Claims Processing Manual, Chapter 35, §50 Therapeutic Procedures

Article Guidance

The Centers for Medicare & Medicaid Services (CMS) has authorized a screening benefit for lung cancer using low dose computed tomography (LDCT) scanning. There are two CPT/HCPCS codes associated with this benefit: G0296 for the initial visit and 71271 for the scan and subsequent intervention. The descriptions for these codes are:

Bill Type Codes

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.

Revenue Codes

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.

Is lung cancer screening recommended?

Jett and Midthun (2011) noted that screening for lung cancer is not currently recommended, even in persons at high-risk for this condition. Most patients with lung cancer present with symptomatic disease that is usually at an incurable, advanced stage.

Does CT reduce lung cancer?

A recent study (Bach et al, 2007) reported that screening current or former smokers for lung cancer with CT increases the rate of diagnosis and treatment, but does not reduce the risk of advanced lung cancer or death from lung cancer.

Is lung cancer a late stage disease?

Lung cancer is often diagnosed at a late stage; as a result, long term survival rates are poor. Detecting the disease and initiating treatment at an early stage are important for improving survival.

What is the best way to detect lung cancer?

A clinical strategy for lung cancer detection that has demonstrated promise is low-dose computed tomography (LDCT), also known as spiral or helical CT scanning.

Does chest x-ray show lung cancer?

Studies have shown that standard chest x-ray screening even when combined with sputum cytology does not decrease lung cancer mortality. Computed tomography (CT) is more sensitive in detecting parenchymal opacities than plain chest radiography; however, the expense, time, and radiation dose has prohibited CT from being considered of use as a screening modality. The latest generation of low-dose CT (LDCT) scanners (also known as spiral CT or helical CT) has the ability to scan the entire thorax in approximately 15 seconds, and the radiation dose used has been reduced to a level equivalent to mammography. Studies have demonstrated that spiral CT can detect small nodules in the lung that are otherwise poorly visible on chest X-ray.

Is lung cancer incurable?

Most patients with lung cancer present with symptomatic disease that is usually at an incurable, advanced stage. The recently reported NLST showed a 20 % decrease in deaths from lung cancer in high-risk persons undergoing screening with LDCT of the chest compared with chest radiography.

Is CXR recommended for lung cancer?

In patients at risk for developing lung cancer, screening for lung cancer with CXR once or at regular intervals is not recommended (Grade 1A). In patients at risk for developing lung cancer, screening for lung cancer with sputum cytology at regular intervals is not suggested (Grade 2B).

Description Information

Please Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

Transmittal Information

08/2015 - The purpose of this Change Request (CR) is to inform contractors that Medicare covers lung cancer screening with low dose computed tomography (LDCT) if all eligibility requirements listed in the National Coverage Determination (NCD) are met. Effective date 02/05/2015. Implementation date: 01/04/2016. ( TN 185 ) (CR9246)

National Coverage Analyses (NCAs)

This NCD has been or is currently being reviewed under the National Coverage Determination process. The following are existing associations with NCAs, from the National Coverage Analyses database.