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Home/Diagnosis/ICD-10 Coding for PSA Screening

ICD-10 Coding for PSA Screening

Z12.5
Z80.42

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

Also Known as:
Prostate-Specific Antigen Screening
Prostate Cancer Screening
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Key Information: ICD-10 Coding for PSA Screening

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

Use ICD-10 code Z12.5 for encounter for screening for malignant neoplasm of prostate, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Encounter for screening for malignant neoplasm of prostate

Billable Code
Z12.5
Billable

Diagnostic Criteria

clinical:
  • • Patient is asymptomatic
  • • Age-appropriate for screening (typically 45-75 years)
coding:
  • • Use Z12.5 for screening, not for diagnostic purposes

Applicable To

  • • Annual prostate cancer screening

Important Notes

  • • Ensure documentation specifies 'screening' to differentiate from diagnostic testing

Family history of malignant neoplasm of prostate

Billable Code
Z80.42
Billable

Diagnostic Criteria

clinical:
  • • Documented family history of prostate cancer

Applicable To

  • • Family history of prostate cancer

Important Notes

  • • Enhances risk adjustment factor when used with Z12.5
Ancillary Codes

Additional codes that may be used with this diagnosis

G0103

Prostate cancer screening; prostate specific antigen test (PSA)

Use with Z12.5 for Medicare-covered screening

Frequently Asked Questions

What is the ICD-10 code for PSA screening?

The ICD-10 code for PSA screening is Z12.5, used for annual prostate cancer screening in asymptomatic patients.

When should Z12.5 be used?

Use Z12.5 for routine annual prostate cancer screening in asymptomatic patients, typically aged 45-75.

How does family history affect PSA screening coding?

If there's a family history of prostate cancer, use Z80.42 as a secondary code with Z12.5.

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