ICD-10-CM Code Z12.39

Encounter for other screening for malignant neoplasm of breast

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z12.39 is a billable code used to specify a medical diagnosis of encounter for other screening for malignant neoplasm of breast. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z12.39 might also be used to specify conditions or terms like attended breast screening clinic, breast neoplasm screening status, breast neoplasm screening status, examines own breasts, patient breast aware, suspected breast cancer, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z12.39 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.

ICD-10:Z12.39
Short Description:Encounter for oth screening for malignant neoplasm of breast
Long Description:Encounter for other screening for malignant neoplasm of breast

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 Z12.39 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:

  • Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual’s health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Synonyms

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

  • Attended breast screening clinic
  • Breast neoplasm screening status
  • Breast neoplasm screening status
  • Examines own breasts
  • Patient breast aware
  • Suspected breast cancer

Present on Admission (POA)

Z12.39 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 Z12.39 to ICD-9

  • V76.10 - Scrn mal neo breast NOS (Approximate Flag)
  • V76.19 - Scrn mal neo breast NEC (Approximate Flag)

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)

Code History

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

Information for Patients


Breast Cancer

Breast cancer affects one in eight women during their lives. No one knows why some women get breast cancer, but there are many risk factors. Risks that you cannot change include

  • Age - the risk rises as you get older
  • Genes - two genes, BRCA1 and BRCA2, greatly increase the risk. Women who have family members with breast or ovarian cancer may wish to be tested for the genes.
  • Personal factors - beginning periods before age 12 or going through menopause after age 55

Other risks include obesity, using hormone replacement therapy (also called menopausal hormone therapy), taking birth control pills, drinking alcohol, not having children or having your first child after age 35, and having dense breasts.

Symptoms of breast cancer may include a lump in the breast, a change in size or shape of the breast, and discharge from a nipple. Breast self-exams and mammography can help find breast cancer early, when it is most treatable. One possible treatment is surgery. It could be a lumpectomy or a mastectomy. Other treatments include radiation therapy, chemotherapy, hormone therapy, and targeted therapy. Targeted therapy uses substances that attack cancer cells without harming normal cells.

Men can have breast cancer, too, but it is rare.

NIH: National Cancer Institute


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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

  • Breast cancer and cervical cancer in women
  • Colorectal cancer
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Osteoporosis
  • Overweight and obesity
  • Prostate cancer in men

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


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