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Home/Diagnosis/ICD-10 Coding for Routine Mammogram

ICD-10 Coding for Routine Mammogram

Z12.31
Z85.3

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

Also Known as:
Screening Mammogram
Preventive Mammogram
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Key Information: ICD-10 Coding for Routine Mammogram

Essential facts and insights about ICD-10 Coding for Routine Mammogram

Use ICD-10 code Z12.31 for encounter for screening mammogram for malignant neoplasm of breast, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Encounter for screening mammogram for malignant neoplasm of breast

Billable Code
Z12.31
Billable

Diagnostic Criteria

clinical:
  • • Patient is over 40 years old and asymptomatic.
documentation:
  • • Documentation must state 'routine screening' and 'asymptomatic'.

Applicable To

  • • Routine screening mammogram

Important Notes

  • • Ensure documentation clearly states the screening nature of the mammogram.

Personal history of malignant neoplasm of breast

Billable Code
Z85.3
Billable

Applicable To

  • • History of breast cancer

Important Notes

  • • Ensure history of breast cancer is documented.
Ancillary Codes

Additional codes that may be used with this diagnosis

+77063

Screening digital breast tomosynthesis (DBT)

Use as an add-on for digital breast tomosynthesis during screening.

Frequently Asked Questions

What is the ICD-10 code for a routine mammogram?

The ICD-10 code for a routine mammogram is Z12.31, used for asymptomatic patients undergoing screening for breast cancer.

How often should a routine mammogram be coded?

Routine mammograms should be coded annually for women over 40, using Z12.31, unless otherwise indicated by personal or family history.

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