2025 ICD-10-CM code Z12.79
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Screening - Persons encountering health services for examinations Chapter 21: Factors influencing health status and contact with health services Feed
Encounter for screening for malignant neoplasm of other genitourinary organs.
Modifiers may be applicable depending on the specific services provided in conjunction with the screening examination.
Medical necessity for screening examinations is determined based on established guidelines and risk factors. This might include age, family history of cancer, personal risk factors, and the availability of effective screening methods.Payers may have specific coverage criteria for these procedures.
The clinical responsibility lies with the physician or qualified healthcare professional conducting the screening examination. This includes ordering and interpreting relevant diagnostic tests and providing counseling based on the results.
- Chapter 21: Factors influencing health status and contact with health services
- Z12- Encounter for screening for malignant neoplasm
In simple words: This code is used when someone goes to the doctor for a checkup to screen for cancer in the urinary or genital areas (excluding the cervix, vagina, and uterus).The doctor might order tests to look for any signs of cancer.
This ICD-10-CM code signifies a healthcare encounter where the primary reason for the visit is a screening examination for a malignant neoplasm (cancer) in the genitourinary organs, excluding the cervix, vagina, and uterus.The screening may involve various diagnostic tests, such as imaging or laboratory procedures, depending on the clinical setting and physician's judgment.
Example 1: A 55-year-old male patient with a family history of prostate cancer presents for a routine screening prostate-specific antigen (PSA) blood test. This would be coded as Z12.79., A 60-year-old female patient, asymptomatic, undergoes a screening ultrasound of the kidneys and bladder as part of a comprehensive cancer screening panel. This would be coded as Z12.79., A 40-year-old female patient with a personal history of a benign kidney tumor undergoes a follow-up screening CT scan of her kidneys, which is negative for malignancy. This would be coded as Z12.79.
Documentation should include the reason for the screening, the specific tests performed (e.g., PSA test, imaging studies), the results of the tests, and any counseling or further recommendations provided to the patient.The documentation should also clearly indicate that the examination was performed for screening purposes and not because of symptoms or other findings suggestive of cancer.The medical record should clearly identify which genitourinary organs were included in the screening process.
** This code should not be used for diagnostic examinations performed because of symptoms.If there are any findings suggestive of malignancy during the screening, additional codes should be used to specify the findings.
- Payment Status: Active
- Specialties:Urology, Oncology, Family Medicine
- Place of Service:Office, Outpatient Hospital, Clinic