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Home/Diagnosis/ICD-10 Coding for Colonoscopy Screening

ICD-10 Coding for Colonoscopy Screening

Z12.11
Z80.0
Z86.010

Complete ICD-10-CM coding and documentation guide for icd-10 coding for colonoscopy screening includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Colorectal Cancer Screening
Preventive Colonoscopy
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Key Information: ICD-10 Coding for Colonoscopy Screening

Essential facts and insights about ICD-10 Coding for Colonoscopy Screening

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

clinical:
  • • Patient is asymptomatic and over 45 years old.
documentation:
  • • Screening intent is clearly documented.

Applicable To

  • • Routine screening colonoscopy

Important Notes

  • • Always sequence Z12.11 first, even if polyps or cancer are found.

Family history of malignant neoplasm of digestive organs

Billable Code
Z80.0
Billable

Diagnostic Criteria

clinical:
    documentation:

      Applicable To

      • • Family history of colorectal cancer

      Important Notes

      • • Supports high-risk screening classification.

      Personal history of colonic polyps

      Non-Billable
      Z86.010
      Non-Billable

      Diagnostic Criteria

      clinical:
        documentation:

          Applicable To

          • • History of adenomatous polyps

          Important Notes

          • • Indicates surveillance due to prior polyps.
          Ancillary Codes

          Additional codes that may be used with this diagnosis

          Z80.0

          Family history of malignant neoplasm of digestive organs

          Use to indicate high-risk screening due to family history.

          Frequently Asked Questions

          What is the ICD-10 code for colonoscopy screening?

          The ICD-10 code for colonoscopy screening is Z12.11, used for all screening colonoscopies regardless of findings.

          How do you code a colonoscopy with polyp removal?

          For a colonoscopy with polyp removal, use Z12.11 as primary, followed by the polyp code, and add modifier PT for Medicare.

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