2022 ICD-10-CM Code Z12.11

Encounter for screening for malignant neoplasm of colon

Version 2021

Valid for Submission

ICD-10:Z12.11
Short Description:Encounter for screening for malignant neoplasm of colon
Long Description:Encounter for screening for malignant neoplasm of colon

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons encountering health services for examinations (Z00-Z13)
      • Encounter for screening for malignant neoplasms (Z12)

Z12.11 is a billable diagnosis code used to specify a medical diagnosis of encounter for screening for malignant neoplasm of colon. The code Z12.11 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.

The ICD-10-CM code Z12.11 might also be used to specify conditions or terms like screening for malignant neoplasm of colon done. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z12.11 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.

The code Z12.11 is linked to some Quality Measures as part of Medicare's Quality Payment Program (QPP). When this code is used as part of a patient's medical record the following Quality Measures might apply: Appropriate Follow-up Interval For Normal Colonoscopy In Average Risk Patients.

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Z12.11:


Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z12.11 are found in the index:

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

Present on Admission (POA)

Z12.11 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Z12.11 to ICD-9 Code

Quality Payment Program Measures

When code Z12.11 is part of the patient's diagnoses the following Quality Measures apply and affect reimbursement. The objective of Medicare's Quality Measures is to improve patient care by making it more: effective, safe, efficient, patient-centered and equitable.

Quality Measure Description Quality Domain Measure Type High Priority Submission Methods
Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk PatientsPercentage of patients aged 50 to 75 years of age receiving a screening colonoscopy without biopsy or polypectomy who had a recommended follow-up interval of at least 10 years for repeat colonoscopy documented in their colonoscopy report.Communication and Care CoordinationProcessYESClaims, Registry

Information for Patients


Health Screening

Screenings are tests that look for diseases before you have symptoms. Screening tests can find diseases early, when they're easier to treat. You can get some screenings in your doctor's office. Others need special equipment, so you may need to go to a different office or clinic.

Some conditions that doctors commonly screen for include

Which tests you need depends on your age, your sex, your family history, and whether you have risk factors for certain diseases. After a screening test, ask when you will get the results and whom to talk to about them.

Agency for Healthcare Research and Quality


[Learn More in MedlinePlus]

Colorectal Cancer Screening (PDQ®) Learn about colorectal cancer screening tests used to find changes in the colon or rectum before cancer develops.
[Learn More in MedlinePlus]

Tests to Detect Colorectal Cancer and Polyps Learn about the methods used to screen for colorectal cancer. This fact sheet also discusses the advantages and disadvantages of several colorectal cancer screening tests.
[Learn More in MedlinePlus]

Code History

  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)