Z12.31

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I'm curious if coding Z12.31 with an E/M is appropriate my provider, patients PCP, is referring patients for a Mammogram Screening and utilizing Z12.31 as a DX in his A/P. I do not feel this is appropriate since we are not actually performing the Mammogram. What do you think?
 

thomas7331

True Blue
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You are correct - this code should be used only if the screening took place at the encounter. Per ICD-10 guidelines "A screening code may be a first-listed code if the reason for the visit is specifically the screening exam. It may also be used as an additional code if the screening is done during an office visit for other health problems."
 

momo2

Networker
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Screening Z Codes/Status 1 Codes

Hello,

My providers have a tendency to use the Screening Z codes when they are referring patient's for a particular screening like prostate cancer. I agree that the providers should not be using these codes if the screening is not performed at the encounter (like in the office visit).

I have 2 questions:

If a patient presents in their PCP's office and is not sick but needs a referral to an OB, what code should be used? I was originally thinking Z33.1, Pregnant, incidental, however, I thought that code should only be used if a pregnant patient was coming into their PCP's office for a sick visit?

If a patient presents to their PCP after a Motor Vehicle accident and is perfectly fine, what code would be used? Z04.1? Encounter for person involved in a transport accient?

Thanks so much for any help with these!!
 
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