Comprehensive ICD-10 Coding Guide for Lung Cancer Screening

Lung cancer remains one of the top causes of cancer-related deaths globally, but the good news is that early detection through screening can save lives. Medical professionals play a vital role in this process — not only by recommending screening but also by ensuring proper ICD-10 coding for documentation and billing.

This comprehensive 2025 guide from Best Writes Links explains everything you need to know about the correct ICD-10 codes for lung cancer screening, how to apply them accurately, and how to ensure smooth insurance coverage.

? What Is Lung Cancer Screening?

Lung cancer screening is a preventive test used to find lung cancer before symptoms appear. The recommended method is the Low-Dose Computed Tomography (LDCT) scan.

An LDCT scan uses low levels of radiation to produce detailed images of the lungs. It helps identify small nodules or tumours at an early stage — when treatment is most effective.

Screening is mainly intended for people at high risk due to a long history of smoking. It’s one of the few proven ways to reduce the number of deaths caused by lung cancer.

? Importance of Accurate ICD-10 Coding

The ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) coding system is essential for documenting and tracking patient diagnoses.

When used correctly, ICD-10 codes help:

• Identify preventive screenings versus diagnostic visits
  
  

• Ensure insurance coverage for preventive care.e
  
  

• Support accurate medical billing and reimbursement..t
  
  

• This data provides valuable insights for public health research. h
  
  

• Maintain regulatory compliance in clinical documentation.
  
  

Incorrect or incomplete coding can lead to claim denials and inaccurate reporting, which can impact both the healthcare provider and the patient.

? Primary ICD-10 Code for Lung Cancer Screening

The main ICD-10 code used for lung cancer screening is:

Z12.2 — Encounter for screening for malignant neoplasm of respiratory organs

✅ Use Z12.2 when:

• The visit is for preventive lung cancer screening.
  .

• The patient has no symptoms of lung cancer.r
  
  

• The test ordered is a Low-Dose CT (LDCT) scan.
  
  

This code distinguishes screening from diagnostic tests that are performed due to symptoms like coughing, chest pain, or weight loss.

⚕️ Secondary ICD-10 Codes for Smoking History

Because most lung cancer screening programs are based on smoking history, you must include a secondary code to document current or past tobacco use.

Standard supporting ICD-10 codes include:

• F17.210 — Nicotine dependence, cigarettes, uncomplicated
  
  

• F17.211 — Nicotine dependence, in remission
  
  

• Z87.891 — Personal history of nicotine dependence
  
  

Including one of these codes helps justify the medical necessity of screening and ensures compliance with payer policies.

? ICD-10 Codes for Abnormal Findings

If a lung cancer screening identifies any abnormal results, you’ll need to add additional codes that describe those findings.

Common codes include:

• R91.1 — Solitary pulmonary nodule
  
  

• R91.8 — Other nonspecific abnormal findings of the lung field
  
  

If lung cancer is later diagnosed after further tests, replace the screening code with a C34.x code that specifies the cancer’s exact location, such as:

• C34.10 — Malignant neoplasm of upper lobe, unspecified bronchus or lung
  
  

? ICD-10 Example for Lung Cancer Screening Documentation

Scenario:
A 62-year-old current smoker with a 30-pack-year history comes in for an annual LDCT lung cancer screening.

Correct Coding:

• Z12.2 — Encounter for screening for malignant neoplasm of respiratory organs
  
  

• F17.210 — Nicotine dependence, cigarettes, uncomplicated
  
  

If the scan shows a small nodule:

• Add R91.1 — Solitary pulmonary nodule
  
  

Documentation Tip:
Clearly note that the screening is preventive and intended for patients who meet the USPSTF (U.S. Preventive Services Task Force) eligibility criteria.

? Screening Eligibility Criteria for 2025

According to the USPSTF guidelines, lung cancer screening is recommended for individuals who meet these conditions:

• Age: 50–80 years
  
  

• Smoking history: At least 20 pack-years (1 pack/day for 20 years or two packs/day for 10 years)
  
  

• Status: Current smoker or quit within the past 15 years
  
  

• Symptoms: No signs of lung cancer
  
  

Screening should stop when a person hasn’t smoked for 15 years or develops a serious health condition that limits life expectancy or surgical options.

Accurately documenting these criteria helps justify medical necessity for insurance coverage.

? Billing and Coverage Guide for Lung Cancer Screening

Proper coding ensures accurate billing and reimbursement for LDCT screenings. Here’s how to bill effectively in 2025:

✅ 1. Use the Correct ICD-10 Codes

• Primary: Z12.2 (screening for malignant neoplasm of respiratory organs)
  
  

• Secondary: F17.210, F17.211, or Z87.891 (smoking history)
  
  

✅ 2. Include the Correct CPT/HCPCS Code

• G0297 — Low-Dose CT scan for lung cancer screening
  
  

✅ 3. Add Finding Codes if Needed

If the LDCT identifies nodules or other abnormalities, add R91.1 or R91.8.

✅ 4. Verify Coverage Requirements

Most insurance companies — including Medicare — cover annual LDCT screening when eligibility and documentation requirements are met.

✅ 5. Document the Purpose Clearly

Always note:

“Preventive lung cancer screening (LDCT) per USPSTF guidelines for high-risk patients.”

This clear documentation helps avoid claim denials and ensures payer compliance.

? Example of a Covered Lung Screening Claim

Patient: 70-year-old, 40 pack-year smoking history, current smoker
Visit purpose: Annual preventive LDCT lung cancer screening

Coding and Billing:

• ICD-10 Codes: Z12.2 (screening) + F17.210 (nicotine dependence)
  
  

• CPT/HCPCS Code: G0297
  
  

• Documentation: “Preventive LDCT per USPSTF guidelines; no symptoms of lung cancer.”
  
  

This combination ensures both accurate billing and full insurance coverage under preventive care benefits.

? Benefits of Accurate ICD-10 Coding

Proper ICD-10 documentation benefits everyone involved in the healthcare process:

✅ For Patients:

• Ensures access to covered preventive screenings
  
  

• Promotes early detection and better outcomes
  
  

✅ For Providers:

• Reduces claim rejections and delays
  
  

• Ensures compliance with coding standards
  
  

• Improves data tracking for patient outcomes
  
  

✅ For Healthcare Systems:

• Supports accurate public health reporting
  
  

• Improves population-based cancer prevention programs
  
  

Accurate coding is more than an administrative task — it’s a cornerstone of adequate healthcare.

? Common Mistakes to Avoid

? Using the wrong code (diagnostic vs. screening).
Always use Z12.2 for asymptomatic patients coming in for preventive screening.

? Omitting smoking history codes.
Include F17.210 or Z87.891 to support eligibility and coverage.

? Leaving out CPT/HCPCS codes.
Remember to pair ICD-10 codes with G0297 for LDCT screening.

? Not documenting USPSTF criteria.
Insurers often require evidence that patients meet national screening guidelines.

? Final Thoughts

Lung cancer screening can save lives through early detection — but it also depends on accurate coding and documentation. By using the correct ICD-10 codes, healthcare providers ensure patients receive preventive screenings covered by insurance without delays or denials.

To summarise

• Z12.2 is the main screening code.
  
  

• F17.210 or Z87.891 should support smoking history.
  
  

• G0297 is used for the LDCT procedure.
  
  

• Add R91.1 or R91.8 if abnormalities are found.
  
  

At Best Writes Links, we provide clear, up-to-date medical information to help clinicians and coders stay compliant and confident. With accurate ICD-10 coding, you not only simplify billing but also strengthen preventive care — one screening at a time.