Z12.0 ICD-10-CM Code: Encounter for screening for malignant neoplasm of stomach
Z12.0 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software
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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Persons encountering health services for examinations (Z00-Z13)
Z12.0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceEncounter for screening for malignant neoplasm of stomach
A screening visit to check for stomach cancer in a patient without symptoms or known disease.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- 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.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Z12.0 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z12.0 in this effective period.
Excludes 1
Official- encounter for diagnostic examination-code to sign or symptom
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z12.0 in this effective period.
Use Additional
Official- code to identify any family history of malignant neoplasm (Z80.-)
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z12.0 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is Z12.0 an HCC code?
No. Z12.0 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- Z12.0
- Description
- Encounter for screening for malignant neoplasm of stomach
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Z12.0 is the ICD-10-CM diagnosis code for encounter for screening for malignant neoplasm of stomach. A screening visit to check for stomach cancer in a patient without symptoms or known disease. Z12.0 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons encountering health services for examinations (z00-z13).
Z12.0 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Use this code only when the encounter is specifically for cancer screening, not for diagnostic workup of symptoms.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z12.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the encounter is specifically for cancer screening, not for diagnostic workup of symptoms
- •Do not use if the patient has a personal or family history of stomach cancer; those may require different codes