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2025 ICD-10-CM code Z12.72

Encounter for screening for malignant neoplasm of the vagina.

Refer to the official ICD-10-CM coding guidelines for detailed instructions on the appropriate use of this code. Ensure proper documentation supports the medical necessity of the screening.

Modifiers are not applicable to ICD-10 codes.

Medical necessity for vaginal cancer screening is determined based on the patient's age, risk factors (e.g., history of abnormal Pap smears, sexually transmitted infections, or family history of vaginal cancer), and the healthcare provider's assessment.Follow payer guidelines for coverage criteria.

The clinical responsibility for this code lies with the physician or healthcare professional performing the screening examination and interpreting the results. This may involve a gynecologist, family physician, or other qualified healthcare provider.

IMPORTANT:If the screening is for cervical cancer, Z12.4 should be used. For screening of other genitourinary organs, use Z12.79.If the encounter is for a routine gynecological exam with or without abnormal findings, codes Z01.411 or Z01.419 are appropriate. Additional codes may be needed to identify the absence of the uterus (Z90.71-) or family history of malignant neoplasms (Z80.-).

In simple words: This code is used when a woman goes to the doctor for a test to check for vaginal cancer, even if she doesn't have any symptoms.It's a screening test, like a Pap smear, to look for cancer early.

This ICD-10-CM code signifies an encounter for a screening examination specifically focused on detecting malignant neoplasms (cancer) of the vagina.It is used when a patient presents for a vaginal Pap smear or other screening test for vaginal cancer, in the absence of any signs, symptoms, or a history suggestive of vaginal cancer. The code is applicable to female patients and should be used when the screening is performed for a non-malignant condition.If the hysterectomy was performed for a malignant condition, code Z08 should be used instead.Additional codes may be necessary to specify any related conditions, such as acquired absence of the uterus (Z90.71-).

Example 1: A 50-year-old woman with no history of vaginal cancer or symptoms undergoes a routine Pap smear as part of her annual wellness exam., A 35-year-old woman who has had a hysterectomy for a benign condition undergoes a vaginal Pap smear as part of her annual preventative care., A 62-year-old woman with a history of abnormal Pap smears in the past undergoes a follow-up vaginal Pap smear to monitor for any potential malignancy.

Documentation should include the date of the screening, the type of screening test performed (e.g., Pap smear), the results of the test, and any follow-up recommendations or plans.

** This code is used for screening purposes only. If abnormal findings are present, additional codes should be used to document the specific diagnosis.This code is POA exempt.

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