ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesZ12.11

Z12.11

Encounter for screening for malignant neoplasm of colon

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z12.11 is a billable code used to indicate a diagnosis of encounter for screening for malignant neoplasm of colon.

Key Diagnostic Point:

Z12.11 is used to indicate an encounter for screening for malignant neoplasm of the colon. This code is essential in preventive healthcare, as it reflects the proactive measures taken to identify colorectal cancer in asymptomatic individuals. Screening is crucial, especially for populations at higher risk due to factors such as age, family history, lifestyle choices, and socioeconomic status. Social determinants of health, including access to healthcare, education, and community resources, significantly influence screening rates. Preventive care through regular screenings can lead to early detection, which is associated with improved outcomes and reduced mortality rates. The use of this code is vital for tracking public health initiatives aimed at increasing screening rates and addressing disparities in healthcare access.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate patient history and risk factor documentation
  • Understanding of screening guidelines and age recommendations
  • Differentiation from diagnostic codes if symptoms arise
  • Awareness of payer-specific requirements for preventive services

Audit Risk Factors

  • Inadequate documentation of patient risk factors
  • Failure to follow up on abnormal screening results
  • Incorrect sequencing of codes when symptoms are present
  • Lack of evidence for preventive service eligibility

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation must include patient history, risk factors, and adherence to screening guidelines.

Common Clinical Scenarios

Routine checkups where screening is recommended based on age and risk factors.

Billing Considerations

Consideration of social determinants such as access to care and patient education on screening importance.

Public Health

Documentation Requirements

Documentation should include population-level data and individual screening outcomes.

Common Clinical Scenarios

Community health initiatives promoting colorectal cancer screening.

Billing Considerations

Focus on tracking health disparities and improving access to screening services.

Coding Guidelines

Inclusion Criteria

Use Z12.11 When
  • Z codes are used when a patient is not currently ill but is receiving preventive services
  • 11 should be sequenced as the primary diagnosis when the encounter is solely for screening
  • Payer requirements may vary, so coders should verify specific guidelines for preventive services

Exclusion Criteria

Do NOT use Z12.11 When
No specific exclusions found.

Related CPT Codes

45378CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used when a colonoscopy is performed following a positive screening result.

Documentation Requirements

Document the indication for the procedure and any findings.

Specialty Considerations

Primary care providers should ensure that screening results are communicated effectively.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding, which helps in tracking screening rates and outcomes more effectively. Z12.11 provides a clear indication of preventive care encounters.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding, which helps in tracking screening rates and outcomes more effectively. Z12.11 provides a clear indication of preventive care encounters.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding, which helps in tracking screening rates and outcomes more effectively. Z12.11 provides a clear indication of preventive care encounters.

Resources

Clinical References

  • •
    Colorectal Cancer Screening Guidelines

Coding & Billing References

  • •
    Colorectal Cancer Screening Guidelines

Frequently Asked Questions

When should Z12.11 be used?

Z12.11 should be used when a patient is undergoing screening for colorectal cancer without any presenting symptoms. It is important to document the patient's risk factors and adherence to screening guidelines.