Z12.5Encounter for screening for malignant neoplasm of prostate

Z12.5 is the ICD-10-CM diagnosis code for encounter for screening for malignant neoplasm of prostate. It belongs to category Z12 (encounter for screening for malignant neoplasms), block Z00-Z13 (persons encountering health services for examinations) and chapter 21 (factors influencing health status and contact with health services). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within Z12 (encounter for screening for malignant neoplasms), Z12.5 is specifically for encounter for screening for malignant neoplasm of prostate. Related codes cover neoplasm of stomach (Z12.0), neoplasm of intestinal tract (Z12.1), neoplasm of respiratory organs (Z12.2), neoplasm of breast (Z12.3), neoplasm of cervix (Z12.4), neoplasm of bladder (Z12.6), neoplasm of other genitourinary organs (Z12.7), neoplasm of other sites (Z12.8) and 1 more.

Use an additional code to identify any family history of malignant neoplasm (Z80.-).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 951 (Other Factors Influencing Health Status, relative weight 0.5577), in MDC 23 (Factors Influencing Health Status and Other Contacts with Health Services), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It is on the CMS list of diagnoses consistent only with male patients (the sex-conflict edit itself was retired in FY2025).

It is exempt from present-on-admission (POA) reporting, so no POA indicator is required.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as V76.44 (screening for malignant neoplasms of prostate).