what icd-10-cm code is reported for a routine screening mammogram

by Theresa Turcotte 8 min read

An ICD-10-CM diagnosis code(s) should be linked to the appropriate CPT mammography code reported. The proper diagnosis code to report would be Z12. 31, Encounter for screening mammogram for malignant neoplasm of breast.

What diagnosis code is used for routine breast mammography?

ICD-10-CM Diagnosis Code Z12.31. Encounter for screening mammogram for malignant neoplasm of breast. 2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code POA Exempt. Type 1 Excludes. inconclusive mammogram ( R92.2) ICD-10-CM Diagnosis Code Z39.2 [convert to ICD-9-CM] Encounter for routine postpartum follow-up.

What does ICD 10 do you use for EKG screening?

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. POA Indicators on CMS form 4010A are as follows: Coding Notes for Z12.31 Info for medical coders on how to properly use this ICD-10 code

What to expect from your screening mammogram?

Nov 08, 2019 · Z12. 31, Encounter for screening mammogram for malignant neoplasm of breast, is the primary diagnosis code assigned for a screening mammogram. If the mammogram is diagnostic, the ICD-10-CM code assigned is the reason the diagnostic mammogram was performed. What is the difference between Z12 31 and Z12 39?

What is the ICD 10 code for MRSA screening?

Oct 01, 2021 · ICD-10-CM Code. Z12.31. Z12.31 is a valid billable ICD-10 diagnosis code for Encounter for screening mammogram for malignant neoplasm of breast . It is found in the 2022 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2021 - Sep 30, 2022 .

What ICD-10-CM code is reported for a routine screening mammogram quizlet?

Look in the ICD-10-CM Alphabetic Index for Screening/neoplasm (malignant) (of)/breast/routine mammogram and you are guided to Z12. 31.

What is the code for mammogram?

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

What ICD-10-CM code is reported for a routine exam when an abnormal finding is found?

Z00.012022 ICD-10-CM Diagnosis Code Z00. 01: Encounter for general adult medical examination with abnormal findings.

What is the procedural code for diagnostic mammogram of both breasts?

These 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 the ICD 10 code for abnormal mammogram?

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

What is the CPT code for screening breast ultrasound?

CPT code 76641 for breast ultrasound represents a complete examination of all four quadrants of the breast and the retroareolar region. On the other side, the limited code, 76642, is for a focused exam of the breast that is limited to one or more of the elements included in 76641.Oct 2, 2020

What ICD-10 code for routine labs?

From ICD-10: For encounters for routine laboratory/radiology testing in the absence of any signs, symptoms, or associated diagnosis, assign Z01. 89, Encounter for other specified special examinations.Feb 24, 2022

What is the ICD-10 code for routine preventive exam?

The adult annual exam codes are as follows: Z00. 00, Encounter for general adult medical examination without abnormal findings, Z00.

What ICD-10-CM codes are reported for a radiotherapy session?

2022 ICD-10-CM Diagnosis Code Z51. 0: Encounter for antineoplastic radiation therapy.

How do you code a unilateral screening mammogram?

77065, Diagnostic mammography, including CAD when performed; unilateral. 77066, Diagnostic mammography, including CAD when performed; bilateral. 77067, Screening mammography, bilateral (two-view study of each breast), including CAD when performed.

What is the difference between bilateral and unilateral mammogram?

There are two types of diagnostic mammogram – unilateral and bilateral. Unilateral diagnostic mammograms examine only one breast, whereas bilateral mammograms take images of both breasts.

Which modifier indicates diagnostic mammogram from screening mammogram on same day?

When submitting a claim for a screening mammography and a diagnostic mammography for the same patient on the same day, attach Modifier GG to the diagnostic mammography. Medicare requires Modifier GG be appended to the claim for the diagnostic mammogram for tracking and data collection purposes.

What is the ICd 10 code for health status?

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:

What is a Z code?

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. A procedure code is required to confirm ...

What is a screening test?

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). Screening differs from diagnostic examination, in which testing occurs in a patient with signs and symptoms to rule out or confirm a suspected diagnosis. If a test is to qualify as a screening, the patient must be asymptomatic for the condition being tested.#N#ICD-10-CM provides Z codes to identify screening as the reason for a test or exam, using the following broad categories:#N#Z11 Encounter for screening for infectious and parasitic diseases#N#Z12 Encounter for screening for malignant neoplasms#N#Z13 Encounter for screening for other diseases and disorders#N#Except: Z13.9 Encounter for screening, unspecified#N#Z36 Encounter for antenatal screening of mother#N#Within each category, individual codes identify specific screening services (e.g., Z13.6 Encounter for screening for cardiovascular disorders ).#N#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. A procedure code is required to confirm the screening was performed.#N#Example 1: A 60-year-old male patient presents to the outpatient radiology department for a lower gastrointestinal (GI) examination. The physician’s order documented lower GI screening. The radiology report notes intestinal infectious disease in lower GI. The first listed diagnosis is Z13.811 Encounter for screening for lower gastrointestinal disorder, with an additional diagnosis of Z11.0 Encounter for screening for intestinal infectious diseases.#N#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.#N#If a condition is discovered during the screening, you may assign the code for the condition as an additional diagnosis. For example, a 75-year-old female patient presents to the radiology department for a left side mammogram. The doctor’s order documented breast cancer screening and dense breast on the left side. Proper coding is Z12.31 Encounter for screening mammogram for malignant neoplasm of breast and R92.2 Inconclusive mammogram.

Who is Sivaraj Ramesh?

Sivaraj Ramesh, CPC, CEMC, CCS, is a team manager in healthcare quality – digital operations for Cognizant Technology Solutions. He has a professional degree in physical therapy, a master’s degree in psychology, and has completed Lean Six Sigma Black Belt. Ramesh has more than 11 years of experience in the management, medical coding, auditing, and revenue cycle sectors, and in coder and auditor calibration, new training module program creation, with multispecialty expertise in radiology, evaluation and management, and surgery. He is a member of the Chennai, India, local chapter.