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ICD 10 code for Encounter for screening for malignant neoplasm of prostate. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code Z12.5.
The ICD-10-CM code to use for annual screening services is Z12.5, Encounter for screening for malignant neoplasm of prostate. Codes in the Z12 category have a “Use additional code” instruction if there is family history of the disease.
Prostate Specific Antigen. CPT: 84153. The ICD10 codes listed below are the top diagnosis codes currently utilized by ordering physicians for the limited coverage test highlighted above that are also listed as medically supportive under Medicare’s limited coverage policy.
Z12.5 is a billable diagnosis code used to specify a medical diagnosis of encounter for screening for malignant neoplasm of prostate. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2024 through September 30, 2025.
Medically Necessary: Prostate specific antigen (PSA) testing is considered medically necessary for any of the following indications: Screening for prostate cancer, or. Evaluation of signs or symptoms suggestive of prostate cancer; or. Individuals with previous elevated or rising PSA levels; or.
Prostate Specific Antigen (PSA), a tumor marker for adenocarcinoma of the prostate, can predict residual tumor in the post-operative phase of prostate cancer. Three to six months after radical prostatectomy, PSA is reported to provide a sensitive indicator of persistent disease.
The ICD-10 diagnosis code to support either screening is Z12.5 Encounter for screening for malignant neoplasm of prostate. There is no deductible or coinsurance/co-payment for the PSA test, but there is for the screening DRE under Medicare Part B.
Search Page 1/7: psa screening. Search Results. 158 results found. Showing 1-25: ICD-10-CM Diagnosis Code Z13.9 [convert to ICD-9-CM] Encounter for screening, unspecified. Screening; Screening done. Z13.9. POA Exempt. ICD-10-CM Diagnosis Code R97.21 [convert to ICD-9-CM] Rising PSA following treatment for malignant neoplasm of prostate.
There are several ICD-10 codes you might use for a diagnostic PSA test (84153). Your urologist might document conditions such as malignant neoplasm of prostate (C61), gross hematuria (R31.0), or elevated PSA (R97.2).
An elevated PSA could be an indication of prostate cancer. Coding/Billing for Prostate Cancer Screening Medicare provides coverage of an annual preventive prostate cancer screening DRE and PSA blood test for all male beneficiaries age 50 and older.