ICD-10 Z12.11
Billable / SpecificEncounter for screening for malignant neoplasm of colon
About ICD-10-CM Z12.11
ICD-10-CM code Z12.11 represents Encounter for screening for malignant neoplasm of colon. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z12). The 2026 edition of ICD-10-CM Z12.11 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under Z12.11. Per CMS ICD-10-CM Tabular 2026.
- Encounter for screening colonoscopy NOS
Medicare LCD Coverage for Z12.11
Local Coverage Determinations (LCDs) from CMS MACs that list Z12.11 as a covered diagnosis.
Showing top 10 of 125 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Z12.11.
3 Cigna
5 Medicare
CPT Codes Commonly Billed with Z12.11
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 45378 Screening colonoscopy — average risk, family history, personal history Gastroenterology
- 45378 Diagnostic colonoscopy — colorectal screening, family hx colon cancer, polyp, melena, iron def anemia, diverticulosis, ulcerative colitis, Crohn, occult blood, rectal polyp, weight loss, IBS Gastroenterology
- 45380 Colonoscopy with biopsy — colon polyp, neoplasm of colon, melena, iron deficiency anemia, screening, personal hx polyps, UC, occult blood Gastroenterology
- 45385 Colonoscopy with polypectomy snare — colon polyps all sites, screening, personal/family hx polyps/cancer Gastroenterology
- 45381 Colonoscopy with directed submucosal injection — polyp removal facilitation, same dx as polypectomy Gastroenterology
- 45384 Colonoscopy with hot biopsy forceps polypectomy — small polyp removal Gastroenterology
- G0105 CMS LCD: Billing and Coding: Screening Colonoscopy Converted to a Diagnostic and/or Therapeutic Colonoscopy CMS LCD
- G2204 CMS LCD: Billing and Coding: Screening Colonoscopy Converted to a Diagnostic and/or Therapeutic Colonoscopy CMS LCD
- G0121 CMS LCD: Billing and Coding: Incomplete Colonoscopy/Failed Colonoscopy CMS LCD
Convert Z12.11 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| Z12.11 | V7651 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Z12.11
Other codes in section Z00-Z13 (Persons encountering health services for examinations).
ICD-10 Z12.11, Billing FAQ
Is ICD-10 code Z12.11 billable? +
Yes, Z12.11 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to Z12.11? +
ICD-10 Z12.11 includes: Encounter for screening colonoscopy NOS.
What CPT codes are commonly billed with Z12.11? +
Procedures frequently paired with Z12.11 include: 45378, 45378, 45380, 45385, 45381.
What ICD-9 codes does Z12.11 map to? +
Per CMS GEMs, Z12.11 maps to ICD-9 codes: V7651. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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