icd 10 code for screening mammogram

by Wilburn Klein 5 min read

Z12. 31, Encounter for screening mammogram for malignant neoplasm of breast, is the primary diagnosis code
diagnosis code
Diagnostic coding is the translation of written descriptions of diseases, illnesses and injuries into codes from a particular classification. In medical classification, diagnosis codes are used as part of the clinical coding process alongside intervention codes.
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assigned for a screening mammogram. If the mammogram is diagnostic, the ICD-10-CM code assigned is the reason the diagnostic mammogram was performed.
Mar 13, 2019

What is the CPT code for mammogram screening?

Oct 01, 2021 · 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.

What is the ICD 10 code for breast exam?

Mar 18, 2021 · Z12. 39 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. What is difference between screening mammogram and diagnostic mammogram? Purpose: Screening mammograms help prevent advanced disease.

What is the ICD 10 code for dense breast?

Jan 28, 2020 · Encounter for screening mammogram for malignant neoplasm of breast. Z12. 31 is a billable/specific ICD-10-CM code that can be used …

Why would a diagnostic mammogram be ordered?

ICD-10-CM Code Z12.31 Encounter for screening mammogram for malignant neoplasm of breast BILLABLE POA Exempt | ICD-10 from 2011 - 2016 Z12.31 is a billable ICD code used to specify a diagnosis of encounter for screening mammogram for malignant neoplasm of breast. A 'billable code' is detailed enough to be used to specify a medical diagnosis.

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What is the difference between Z12 31 and Z12 39?

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.Feb 18, 2019

What is the ICD 10 code for screening?

Z13.99.

What is the CPT code for a diagnostic mammogram?

Group 1CodeDescription77065DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL77066DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; BILATERAL16 more rows

What is an encounter for screening?

Encounter for screening for other diseases and disorders Screening is the testing for disease or disease precursors in asymptomatic individuals so that early detection and treatment can be provided for those who test positive for the disease.

What is Z13 89 ICD-10?

encounter for screening for other disorderCode Z13. 89, encounter for screening for other disorder, is the ICD-10 code for depression screening.Oct 1, 2016

What is the ICD 10 for abnormal mammogram?

793.80 - Abnormal mammogram, unspecified. ICD-10-CM.

What is difference between screening mammogram and diagnostic mammogram?

Screening mammograms are annual preventive exams, while a doctor may order a diagnostic mammogram based on any signs of breast cancer symptoms. A diagnostic mammogram is more detailed than a screening mammogram. A screening mammogram only takes about 10 to 20 minutes, while a diagnostic mammogram can be longer.

What is the CPT code for preventive mammogram screening?

77067These codes are being replaced by the following CPT codes: • 77067 - “screening mammography, bilateral (2-view study of each breast), including CAD when performed” • 77066 - “diagnostic mammography, including (CAD) when performed; bilateral” and • 77065 - “diagnostic mammography, including CAD when performed; ...Nov 24, 2017

What is procedure code 77065?

77065, Diagnostic mammography, including CAD when performed; unilateral. 77066, Diagnostic mammography, including CAD when performed; bilateral. In a perfect world, the new CPT codes would result in uniform coding of mammography services.

What is the difference between a screening mammogram and a diagnostic?

While screening mammograms are routinely administered to detect breast cancer in women who have no apparent symptoms, diagnostic mammograms are used after suspicious results on a screening mammogram or after some signs of breast cancer alert the physician to check the tissue. Such signs may include: A lump.

Does Medicare pay for CPT code 77063?

On Aug. 18, CMS released Change Request (CR) 10181 covering mammography HCPCS code replacement and waiver of coinsurance and deductibles for preventive and other services. For calendar year 2017 Medicare allowed CPT code 77063 to be reported with HCPCS code G0202, not CPT code 77067.

What CPT code replaced g0202?

Change Request (CR) 10181 provides for the replacement of HCPCS codes G0202, G0204, and G0206 with Current Procedural Terminology (CPT) codes 77067, 77066, and 77065, effective January 1, 2018.

What does encounter for screening mean?

Z12 Encounter for screening for malignant neoplasms. Page 1. Z12 Encounter for screening for malignant neoplasms. Screening is the testing for disease or disease precursors in asymptomatic individuals so that early. detection and treatment can be provided for those who test positive for the disease.

How often does medicare pay for a screening mammogram?

With Medicare, you're covered for: one mammogram as a baseline test if you're a woman between the ages of 35 and 49. one screening mammogram every 12 months if you're a woman ages 40 years or older. one or more diagnostic mammograms, if necessary, to diagnose a medical condition, such as breast cancer.

What is breast tomosynthesis?

Breast tomosynthesis, also called three-dimensional (3-D) mammography and digital breast tomosynthesis (DBT), is an advanced form of breast imaging, or mammography, that uses a low-dose x-ray system and computer reconstructions to create three-dimensional images of the breasts.

Coding Notes for Z12.31 Info for medical coders on how to properly use this ICD-10 code

Type-1 Excludes mean the conditions excluded are mutually exclusive and should never be coded together. Excludes 1 means "do not code here."

ICD-10-CM Alphabetical Index References for 'Z12.31 - Encounter for screening mammogram for malignant neoplasm of breast'

The ICD-10-CM Alphabetical Index links the below-listed medical terms to the ICD code Z12.31. Click on any term below to browse the alphabetical index.

Equivalent ICD-9 Code GENERAL EQUIVALENCE MAPPINGS (GEM)

This is the official approximate match mapping between ICD9 and ICD10, as provided by the General Equivalency mapping crosswalk. This means that while there is no exact mapping between this ICD10 code Z12.31 and a single ICD9 code, V76.12 is an approximate match for comparison and conversion purposes.

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

Section 1833 (e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim.

Article Guidance

This article gives guidance for billing, coding, and other guidelines in relation to local coverage policy L33950 Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography.

ICD-10-CM Codes that Support Medical Necessity

It is the responsibility of the provider to code to the highest level specified in the ICD-10-CM. The correct use of an ICD-10-CM code listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in this determination.

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.

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