Lung Cancer Screening: ICD-10 Codes for Billing & Coverage

Lung cancer continues to be a leading cause of cancer-related deaths globally, but early detection can significantly improve survival rates. That’s where Lung cancer screening comes in — a preventive test designed to catch cancer before symptoms appear.

However, for medical providers, proper ICD-10 coding and billing documentation are essential to ensure the screening is covered by insurance and correctly recorded in patient files.

In this detailed 2025 guide from Best Writes Links, we explain the ICD-10 codes, billing procedures, and coverage requirements for lung cancer screening — simplified for healthcare professionals, coders, and clinical staff.

💡 What Is Lung Cancer Screening?

Lung cancer screening is a preventive imaging test that checks for signs of lung cancer in individuals who are at high risk but don’t yet show symptoms.

The standard screening method is Low-Dose Computed Tomography (LDCT). LDCT uses a small amount of radiation to produce clear, detailed images of the lungs and can detect early-stage tumours or nodules that traditional X-rays might miss.

The goal is simple: find and treat lung cancer early, before it spreads or causes severe symptoms.

🧠 Importance of ICD-10 Coding in Screening

In medical practice, ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) codes serve as universal identifiers for diagnoses and services.

When it comes to lung cancer screening, correct ICD-10 coding ensures:

• Accurate documentation in patient records
  
  

• Insurance coverage approval for preventive services
  
  

• Proper medical billing and reimbursement
  
  

• Compliance with national healthcare regulations
  
  

Incorrect or incomplete coding can result in claim denials, delayed payments, or inaccurate medical data — which can affect both providers and patients.

🩺 Primary ICD-10 Code for Lung Cancer Screening

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

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

✅ Use this code when:

• The patient is asymptomatic (no signs of lung cancer)
  
  

• The visit is purely for a preventive screenin..g
  
  

• A Low-Dose CT (LDCT) scan is ordered.red
  
  

This code clearly communicates that the encounter is preventive, not diagnostic. It also helps payers distinguish between screening and testing based on symptoms, which is crucial for coverage decisions.

⚕️ Secondary ICD-10 Codes for Smoking History

Since smoking is the primary risk factor for lung cancer, most payers require additional documentation of a tobacco use or dependence history to justify screening.

Standard secondary ICD-10 codes include:

• F17.210 — Nicotine dependence, cigarettes, uncomplicated
  
  

• F17.211 — Nicotine dependence, in remission
  
  

• Z87.891 — Personal history of nicotine dependence
  
  

These secondary codes support medical necessity and strengthen insurance claims by showing that the patient meets screening eligibility criteria.

🩹 Codes for Abnormal Findings (If Detected)

If an LDCT scan reveals abnormal results, add the appropriate finding codes to the medical record.

Examples include:

• R91.1 — Solitary pulmonary nodule
  
  

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

If a confirmed diagnosis of lung cancer is later made, use the appropriate C34.x code (for malignant neoplasm of bronchus and lung) instead of the screening code.

📋 Screening Eligibility Criteria for Coverage

According to the U.S. Preventive Services Task Force (USPSTF) and major insurance providers, lung cancer screening is covered for individuals who meet the following conditions:

• Age: 50 to 80 years
  
  

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

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

• Health status: No symptoms or signs of lung cancer
  
  

Documenting these criteria ensures that the screening is recognised as medically necessary and qualifies for insurance coverage.

💼 Medical Billing and Coverage Guidelines

Accurate coding and documentation directly affect whether a screening claim is approved or denied. Follow these billing best practices to ensure compliance and smooth reimbursement:

✅ 1. Primary Code

Use Z12.2 as the first-listed diagnosis for preventive LDCT lung screening.

✅ 2. Add Tobacco-Related Codes

Include F17.210, F17.211, or Z87.891 as secondary codes to document the patient’s smoking history.

✅ 3. Procedure (CPT/HCPCS) Code

For the actual LDCT screening, use:

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

✅ 4. Include Finding Codes When Needed

If the scan identifies a nodule or abnormality, add R91.1 or R91.8.

✅ 5. Verify Coverage

Most Medicare and private insurance plans cover annual LDCT lung screenings when documentation meets USPSTF guidelines.

✅ 6. Document the Screening Purpose

Clearly note in the record:

“Preventive lung cancer screening (Low-Dose CT) per USPSTF guidelines — asymptomatic high-risk patient.”

📊 Example of Proper Documentation

Scenario:
A 66-year-old former smoker (40 pack-years, quit 10 years ago) comes for an annual LDCT lung cancer screening.

Coding:

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

• Z87.891 — Personal history of nicotine dependence
  
  

If a small lung nodule is found:

• Add R91.1 — Solitary pulmonary nodule
  
  

This ensures that the medical record and claim clearly indicate the preventive nature of the screening while also capturing relevant clinical details.

🌿 Why Correct Coding Matters

Accurate ICD-10 coding for lung cancer screening:

• Ensures coverage for preventive screenings under insurance and Medicare
  
  

• Prevents claim denials due to incomplete documentation
  
  

• Supports public health tracking for lung cancer data
  
  

• Strengthens clinical accuracy in patient records
  
  

• Enables early detection and better patient outcomes
  
  

Coding isn’t just about billing — it’s about improving healthcare quality through correct data reporting.

🧠 Common Coding Mistakes to Avoid

🚫 Using a diagnostic code instead of a screening code.
Always use Z12.2 for asymptomatic preventive screenings.

🚫 Forgetting to include smoking history codes.
Insurance often requires proof of tobacco use history for eligibility.

🚫 Missing CPT/HCPCS codes.
Pair ICD-10 diagnosis codes with the correct G0297 procedure code for LDCT.

🚫 Not updating abnormal finding codes.
If abnormalities are detected, add R91.1 or R91.8 to support follow-up tests.

🩺 The Role of Best Writes Links

At Best Writes Links, our goal is to make complex medical information easy to understand and apply in real clinical settings. We help healthcare professionals stay compliant, accurate, and informed — especially when dealing with ever-changing ICD-10 codes and billing requirements.

Accurate medical documentation not only ensures correct billing but also helps promote preventive healthcare services, such as lung cancer screening, that save lives every year.

By following these coding and billing tips, clinics and hospitals can improve compliance, reduce claim denials, and provide patients with early access to life-saving care.

✅ Final Thoughts

In 2025, proper ICD-10 coding for lung cancer screening remains crucial for insurance coverage, billing accuracy, and patient care.

To summarise:

• Use Z12.2 as the main ICD-10 code.
  
  

• Add F17.210 or Z87.891 for smoking history.
  
  

• Use G0297 for the LDCT procedure.
  
  

• Include R91.1 or R91.8 if abnormal findings are detected.
  
  

Following these steps ensures smooth billing and compliance with all payer guidelines.

At Best Writes Links, we’re committed to helping medical professionals stay updated with accurate, trusted, and easy-to-understand information — because the correct code can make a life-saving difference.