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Home/Diagnosis/ICD-10 Coding for Cologuard® Stool DNA Testing

ICD-10 Coding for Cologuard® Stool DNA Testing

Z12.11
R19.5
C18.9

Complete ICD-10-CM coding and documentation guide for icd-10 coding for cologuard® stool dna testing includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Stool DNA Test
FIT-DNA Test
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Key Information: ICD-10 Coding for Cologuard® Stool DNA Testing

Essential facts and insights about ICD-10 Coding for Cologuard® Stool DNA Testing

Use ICD-10 code Z12.11 for encounter for screening for malignant neoplasm of colon, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Encounter for screening for malignant neoplasm of colon

Billable Code
Z12.11
Billable

Diagnostic Criteria

  • • Patient is asymptomatic
  • • Documentation states 'average-risk screening'
  • • No personal/family history of CRC

Applicable To

  • • Screening colonoscopy

Important Notes

  • • Ensure documentation specifies 'screening intent' to justify use.

Other fecal abnormalities

Billable Code
R19.5
Billable

Diagnostic Criteria

  • • Cologuard® report showing 'positive for hemoglobin/DNA markers'
  • • No concurrent diarrhea/menstruation

Applicable To

  • • Positive Cologuard® test

Important Notes

  • • Ensure documentation specifies 'positive Cologuard® test'.

Malignant neoplasm of colon, unspecified

Billable Code
C18.9
Billable

Diagnostic Criteria

  • • Pathology confirming adenocarcinoma
  • • Localization (e.g., ascending colon)

Applicable To

  • • Confirmed colorectal cancer

Important Notes

  • • Ensure pathology report is available to support code use.
Ancillary Codes

Additional codes that may be used with this diagnosis

R19.5

Other fecal abnormalities

Use when Cologuard® test is positive.

Frequently Asked Questions

What is the ICD-10 code for a positive Cologuard test?

The ICD-10 code for a positive Cologuard test is R19.5, which indicates abnormal fecal findings. For Medicare, it should be used with Z12.11 to maintain screening intent.

How do you code a colonoscopy after a positive Cologuard test?

For a colonoscopy following a positive Cologuard test, use Z12.11 as the primary code and R19.5 as secondary. For Medicare, append the KX modifier to G0121.

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