ICD-10 Coding for Cecal Polyp(D12.0, K63.5)
Complete ICD-10-CM coding and documentation guide for Cecal Polyp. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cecal Polyp
D12-D37Primary Range
Benign neoplasms and neoplasms of uncertain behavior
This range includes codes for benign and uncertain behavior neoplasms of the digestive system, including cecal polyps.
Other diseases of intestines
This range includes codes for other intestinal conditions, including non-neoplastic polyps like hyperplastic polyps.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D12.0 | Benign neoplasm of cecum | Use when pathology confirms adenomatous features in a cecal polyp. |
|
| K63.5 | Polyp of colon | Use for hyperplastic polyps confirmed by pathology. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for cecal polyp
Essential facts and insights about Cecal Polyp
Primary ICD-10-CM Codes for cecal polyp
Decision Criteria
clinical Criteria
- Pathology confirms adenomatous polyp
coding Criteria
- Screening colonoscopy with adenomatous polyp found
Applicable To
- Adenomatous polyp of cecum
- Tubular adenoma of cecum
Excludes
- Malignant neoplasm of cecum (C18.0)
Clinical Validation Requirements
- Pathology confirms tubular or villous adenoma
- FICEΔE' >1.758
Code-Specific Risks
- Incorrectly coding hyperplastic polyps as adenomatous.
Coding Notes
- Ensure pathology report specifies adenomatous features to use this code.
K63.5 - Polyp of colon
Use for hyperplastic polyps confirmed by pathology.
Applicable To
- Hyperplastic polyp of colon
Excludes
- Adenomatous polyp of colon (D12.x)
Clinical Validation Requirements
- Pathology confirms hyperplastic features
- FICEΔE' ≤1.758
Coding Notes
Ensure pathology report specifies hyperplastic features to use this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Cecal Polyp to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D12.0.
Impact
Clinical: Misrepresentation of polyp type., Regulatory: Non-compliance with ICD-10 coding rules., Financial: Potential for incorrect reimbursement.
Mitigation Strategy
Verify pathology reports before coding., Use decision criteria for code selection.
Impact
Reimbursement: Incorrect sequencing can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data for screening procedures.
Mitigation Strategy
Always list Z12.11 first for screening colonoscopies.
Impact
Incorrect sequencing of screening and findings codes.
Mitigation Strategy
Ensure Z12.11 is always first-listed for screenings.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Cecal Polyp, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cecal Polyp
Use these documentation templates to ensure complete and accurate documentation for Cecal Polyp. These templates include all required elements for proper coding and billing.
Screening Colonoscopy with Polyp Finding
Specialty: GastroenterologyRequired Elements
- Indication for procedure
- Findings during colonoscopy
- Pathology results
- Imaging documentation
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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