Wiki z12.31 vs z12.39

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Code: Z12.31
Encounter for screening mammogram for malignant neoplasm of breast
Excludes 1: inconclusive mammogram (R92.2)
Parent Code Notes: Z12
Excludes1: encounter for diagnostic examination-code to sign or symptom
Use additional code to identify any family history of malignant neoplasm (Z80.-)

Category Notes
Persons encountering health services for examinations (Z00-Z13)
Note: Nonspecific abnormal findings disclosed at the time of these examinations are classified to categories R70-R94.
Excludes 1: examinations related to pregnancy and reproduction (Z30-Z36, Z39.-)

Coding Guidelines
Factors influencing health status and contact with health services (Z00-Z99)
Note: Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
(a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
(b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.


Best answers
Can anyone tell me the difference in Z12.31 and Z12.39? I have some dr's office that use Z12.31 only for Medicare patients? Surely, that is not from a denial of some sort?




True Blue
Columbia, MO
Best answers
The Z12.31 is specific to screening mammograms and the Z12.39 is any screening of the breast other than mammograms. It would be incorrect to use Z12.39 with a screening mammogram.