Z12.31 – Encounter for screening mammogram for malignant neoplasm of breast

Z12.31 – Screen for breast cancer with a mammogram. Detect potential malignant breast tumors through a comprehensive screening. Act now for early detection.

By Priya Singh on Feb 29, 2024.

Fact Checked by Ericka Pingol.

Use Code
Z12.31  – Encounter for screening mammogram for malignant neoplasm of breast

Z12.31 Diagnosis Code: Encounter for screening mammogram for malignant neoplasm of breast

The Z12.31 diagnosis code represents an encounter specifically for screening mammograms to detect the presence of malignant neoplasms (cancerous tumors) in the breast. This diagnostic procedure aims to identify potential breast cancer at its early stages when treatment options are more effective.

Screening mammograms are crucial in early detection and improving breast cancer outcomes. Regular screenings can identify abnormalities, such as lumps or calcifications before they cause noticeable symptoms. Early detection of breast cancer increases the chances of successful treatment and long-term survival.

Medical guidelines recommend mammogram screenings every one to two years for women over 40. However, individual recommendations may vary based on factors such as personal and family medical history. It is important to consult a healthcare provider to determine the appropriate screening schedule.

Is Z12.31 Billable?

Yes, Z12.31 is a billable diagnosis code. It is specifically used to indicate an encounter for a screening mammogram for a malignant neoplasm of the breast. Healthcare providers use diagnosis codes like Z12.31 when submitting claims to insurance companies for reimbursement purposes. 

However, the billability of a code may also depend on factors such as specific insurance coverage and the guidelines of the healthcare system. It is always recommended to consult with healthcare providers and insurance companies to ensure accurate billing practices.

Clinical Information

  • Z12.31 is a diagnosis code used for encounters involving screening mammograms to detect malignant neoplasms (cancerous tumors) in the breast.
  • Screening mammograms are a critical tool in early detection and improving outcomes for breast cancer.
  • A screening mammogram aims to identify potential abnormalities in breast tissue before they cause noticeable symptoms.
  • Regular screenings are recommended for women over 40, although individual recommendations may vary based on personal and family medical history.
  • During a screening mammogram, the breast is compressed between two plates and low-dose X-rays are used to capture detailed images of the breast tissue.
  • These images are then reviewed by radiologists specializing in breast imaging to identify any potential abnormalities or signs of breast cancer.
  • The outcomes of a screening mammogram can be normal findings, benign abnormalities, or suspicious findings that require further evaluation.
  • Benign abnormalities refer to non-cancerous changes in the breast, while suspicious findings may lead to additional tests such as diagnostic mammograms, ultrasounds, or biopsies.
  • The collaborative approach involves patients scheduling regular screenings, openly communicating any breast changes or concerns with their healthcare providers, and following recommended screening guidelines.
  • Early detection through screening mammograms empowers women's health by increasing the chances of successful treatment and long-term survival, ultimately reducing the impact of breast cancer.

Synonyms Include:

  • Breast cancer screening
  • Mammography screening
  • Breast imaging for early detection
  • Diagnostic breast examination
  • Breast cancer surveillance

Other ICD-10 Codes Commonly Used for Mammogram

Here are six commonly used ICD-10 codes for mammogram procedures:

  • Z12.31 - Encounter for screening mammogram for malignant neoplasm of breast
  • Z12.39 - Encounter for other screening for malignant neoplasm of breast
  • Z85.3 - Personal history of malignant neoplasm of breast
  • R92.0 - Mammographic microcalcification found on diagnostic imaging of breast
  • R92.1 - Nipple discharge
  • R92.2 - Inconclusive mammogram
Electronic Health Records Software

Commonly asked questions

Who should undergo a screening mammogram with Z12.31?

In general, women over the age of 40 are recommended to have regular screening mammograms. However, specific guidelines may vary based on personal and family medical history. It is best to consult a healthcare provider to determine the appropriate screening schedule.

How often should a screening mammogram be done?

The recommended frequency for screening mammograms is typically every one to two years for women over 40. However, individual recommendations may vary based on risk factors and healthcare provider guidance.

Does Z12.31 mean a person has breast cancer?

No, Z12.31 is a code used for screening mammograms and does not imply a breast cancer diagnosis. It indicates the purpose of the encounter: to detect potential malignant neoplasms.

What happens during a screening mammogram?

During a screening mammogram, the breast is compressed between two plates, and low-dose X-rays are used to capture images of the breast tissue. Radiologists then review these images to check for any abnormalities.

Join 10,000+ teams using Carepatron to be more productive

One app for all your healthcare work