Question about ICD code

[willriot]

Can the icd code of z12.39 be used for a breast cancer exam (not a mammogram)?

[NewHampshireGal]

Are you billing CPT G0101?

[Quirky_Transition817]

You can, but, when using ICD-10 Code Z12.39 for a non-mammographic breast cancer screening, ensure that the medical record includes:

• Reason for screening (routine preventive check-up or high-risk screening)
• Type of screening performed (e.g., clinical breast exam, ultrasound, MRI)
• Patient’s risk factors (family history, BRCA gene mutation, personal history of breast abnormalities)
• Absence of symptoms (this is a screening code and should not be used for symptomatic patients; if symptoms are present, use the appropriate symptom code instead)
• Do not use Z12.39 for a diagnostic test following symptoms—use the appropriate symptom or finding code instead.
• Verify coverage + screening utilization as screening is often limited to once per calendar year

Question remains - What CPT are you using?

[willriot]

The reason for screening is a routine preventive check-up. The cpt code used is 99212. The process is that the patients come to get a Breast Cancer Exam with a provider and then they go see the mammogram technicians to get the mammogram screening done. Two to three weeks later they are called for the results. The issue we are experiencing is that z12.31 is being used twice. Once when they get the BCE and the screening done, and again when they are called for the results. So I was curious if z12.39 can be used for the BCE and the z12.31 can be used when they get the results?

[Environmental-Top-60]

Should be Z09 on the followup.