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v1.0.0
ICD-10 Guide
DiagnosesScreening Colonoscopy

Screening Colonoscopy

ICD-10 Coding for Screening Colonoscopy(Z12.11, Z80.0)

PRIMARY SPECIALTYGastroenterology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Screening Colonoscopy?
Essential facts and insights about Screening Colonoscopy

Key Clinical Considerations:

  • Asymptomatic individuals aged 45 and older
  • Family history of colorectal cancer or polyps
  • Presence of gastrointestinal symptoms such as rectal bleeding or unexplained weight loss

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history and risk factors
  • Indication for the procedure
  • Findings from the colonoscopy report

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for preventive services to avoid denials.
  • Common errors include using diagnostic codes instead of screening codes.

Code Exclusions

Important Exclusions

  • Patients with known colorectal cancer or inflammatory bowel disease.
  • Codes for diagnostic colonoscopy should not be used for screening purposes.

Related ICD-10 Codes

Primary Codes
Z12.11
Encounter for screening for malignant neoplasm of the colon
Z80.0
Family history of malignant neoplasm of the digestive organs
Ancillary Codes
Z80.0
Differential Codes
K63.5

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Gastroenterology

Specialty Applications

  • Adults aged 45 and older, especially those with risk factors.
  • Outpatient gastroenterology clinics and hospitals.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Documentation must include patient history, indication for the procedure, and findings.

What are the billing considerations?

Ensure correct coding based on indications and document any complications or findings.