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

Billable ICD-10-CM code, FY2026. Exempt from present-on-admission (POA) reporting.

Excludes1 (never code together)

• inconclusive mammogram (R92.2)

Applies from Z12 Encounter for screening for malignant neoplasms

Applicable to

• Screening is the testing for disease or disease precursors in asymptomatic individuals so that early detection and treatment can be provided for those who test positive for the disease.

Excludes1 (never code together)

• encounter for diagnostic examination-code to sign or symptom

Use additional code

• code to identify any family history of malignant neoplasm (Z80.-)

MS-DRG index

Defines the logic of DRG(s) 951 in MDC 23.

Approximate ICD-9-CM (GEMs)

• V76.12 Other screening mammogram (approximate)

Medicare Code Edits (MCE v43.1 (April 2026))

• Unacceptable principal diagnosis: These codes describe a circumstance which influences care but is not a current illness or injury, or capture only an underlying condition, and are unacceptable as principal diagnosis.

Code annotations containing back-references to Z12.31

Back-references to Z12

• Type 2 Excludes: Z00 Encounter for general examination without complaint, suspected or reported diagnosis ("special screening examinations (Z11-Z13)")
• Type 2 Excludes: Z01 Encounter for other special examination without complaint, suspected or reported diagnosis ("screening examinations (Z11-Z13)")
• Type 2 Excludes: Z13.8 Encounter for screening for other specified diseases and disorders ("screening for malignant neoplasms (Z12.-)")

Diagnosis Index entries for Z12.31

• Mammogram (examination) › routine
• Screening (for) › neoplasm (malignant) (of) › breast › routine mammogram
• X-ray (of) › breast (mammogram) (routine)

Nearby codes

• Z12.11 Encounter for screening for malignant neoplasm of colon
• Z12.12 Encounter for screening for malignant neoplasm of rectum
• Z12.13 Encounter for screening for malignant neoplasm of small intestine
• Z12.2 Encounter for screening for malignant neoplasm of respiratory organs
• Z12.3 Encounter for screening for malignant neoplasm of breast
• Z12.31 Encounter for screening mammogram for malignant neoplasm of breast (this code)
• Z12.39 Encounter for other screening for malignant neoplasm of breast
• Z12.4 Encounter for screening for malignant neoplasm of cervix
• Z12.5 Encounter for screening for malignant neoplasm of prostate
• Z12.6 Encounter for screening for malignant neoplasm of bladder
• Z12.7 Encounter for screening for malignant neoplasm of other genitourinary organs