Wiki Breast MRI screening ICD-10 codes.

[szenderskil]

Is anyone else getting claims denied for Screening Breast MRI's when using the new breast density ICD-10 codes?

 

[Jim Pawloski]

Are you using Z12.31?

 

[szenderskil]

I am using Z12.39. I was thinking that with the new breast density codes that Breast MRI's may not be considered a screening when using the new codes and that I should stop using it. Go BLUE!!

 

[whatwouldyousay]

I am using Z12.39. I was thinking that with the new breast density codes that Breast MRI's may not be considered a screening when using the new codes and that I should stop using it. Go BLUE!!

If screening is the indication for MR Breast then Z12.39 is the appropriate PDX with any risk factors and findings assigned after it. You might have specific payers who advise you to submit their claims differently.

 

[whatwouldyousay]

If screening is the indication for MR Breast then Z12.39 is the appropriate PDX with any risk factors and findings assigned after it. You might have specific payers who advise you to submit their claims differently.

The density of the breast is usually why MR screening is indicated over screening mammo. Maybe they’re denying the lower levels of density diagnosis code(s) and not higher ones? Maybe it’s a specific payer? You’re not wrong in assigning the density codes after the screening code however.