ICD-10 Code for Screening Mammography
The ICD-10 code for screening mammography is Z12.31 (Encounter for screening mammogram for malignant neoplasm of breast). 1
Primary Code for Asymptomatic Screening
- Z12.31 is the appropriate code for routine screening mammograms in asymptomatic patients with no breast symptoms, signs, or history of breast disease 1
- This code should be used when ordering screening mammography for preventive purposes rather than diagnostic evaluation 1
- The code applies to all age-appropriate screening scenarios, including women aged 40 and older undergoing annual screening 1
Secondary Codes for Risk Factors
When applicable, add secondary codes to document increased risk:
- Z85.3 for personal history of breast cancer 1
- Z80.3 for family history of malignant neoplasm of breast 1
- Z84.89 for genetic predisposition 1
- Z15.01 for known genetic mutations (such as BRCA1/BRCA2) 1
Special Populations
- High-risk women under age 40 who qualify for screening should still use Z12.31, with appropriate secondary risk factor codes 1
- Transgender patients meeting screening criteria should use Z12.31 for breast cancer screening 1
Critical Coding Pitfalls to Avoid
- Do NOT use diagnostic codes (N60-N65 breast disorders) for screening examinations 1
- Do NOT use Z12.39 (general screening for malignant neoplasm of other sites) when the more specific Z12.31 is appropriate 1
- Do NOT use Z01.89 (encounter for other specified special examinations) as it is too general for breast cancer screening 1
When NOT to Use Z12.31
- If screening reveals an abnormality requiring additional imaging, subsequent visits should be coded with the appropriate diagnostic code rather than Z12.31 1
- For short-interval follow-up of probably benign findings (BI-RADS 3), use the appropriate diagnostic code rather than the screening code 1
- For diagnostic mammography in symptomatic patients or those recalled from screening, use diagnostic codes based on the clinical indication 2