ICD-10 Coding for Colon Polyp with Hemorrhage(D12.5, K51.411)
Complete ICD-10-CM coding and documentation guide for Colon Polyp with Hemorrhage. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Colon Polyp with Hemorrhage
D12-D13Primary Range
Benign neoplasms of the digestive system
Includes adenomatous polyps of the colon which may present with hemorrhage.
Noninfective enteritis and colitis
Includes inflammatory polyps with complications such as bleeding.
Other diseases of intestine
Includes hyperplastic polyps and other intestinal conditions that may involve bleeding.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D12.5 | Benign neoplasm of sigmoid colon | Use when an adenomatous polyp in the sigmoid colon is confirmed with active bleeding. |
|
| K51.411 | Inflammatory polyps with rectal bleeding | Use when bleeding is due to inflammatory polyps, often in the context of inflammatory bowel disease. |
|
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 bleeding colon polyp
Essential facts and insights about Colon Polyp with Hemorrhage
Primary ICD-10-CM Codes for colon polyp with hemorrhage
Decision Criteria
clinical Criteria
- Confirmed adenomatous polyp with bleeding
documentation Criteria
- Endoscopy and pathology reports confirm polyp type and bleeding
Applicable To
- Adenomatous polyp with hemorrhage
Excludes
- Inflammatory polyps (K51.4)
Clinical Validation Requirements
- Endoscopy report showing active bleeding from polyp
- Pathology confirming adenomatous polyp
- Drop in hemoglobin levels
Code-Specific Risks
- Misclassification if polyp type is not specified
Coding Notes
- Ensure documentation specifies polyp type and hemorrhage.
K51.411 - Inflammatory polyps with rectal bleeding
Use when bleeding is due to inflammatory polyps, often in the context of inflammatory bowel disease.
Applicable To
- Bleeding associated with inflammatory bowel disease
Excludes
- Adenomatous polyps (D12.x)
Clinical Validation Requirements
- Endoscopy showing inflammatory polyp with bleeding
- Diagnosis of ulcerative colitis or Crohn's disease
Coding Notes
Ensure documentation specifies inflammatory nature and bleeding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Colon Polyp with Hemorrhage to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D12.5.
Impact
Clinical: May lead to inappropriate follow-up recommendations., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials or incorrect reimbursement.
Mitigation Strategy
Ensure endoscopy reports include polyp type., Train staff on documentation standards.
Impact
Reimbursement: Incorrect coding can lead to denied claims or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data affecting patient records and statistics.
Mitigation Strategy
Ensure documentation specifies whether the polyp is adenomatous or inflammatory.
Impact
Risk of audits due to incorrect coding of polyp type.
Mitigation Strategy
Ensure thorough documentation and staff training.
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 Colon Polyp with Hemorrhage, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Colon Polyp with Hemorrhage
Use these documentation templates to ensure complete and accurate documentation for Colon Polyp with Hemorrhage. These templates include all required elements for proper coding and billing.
Colonoscopy finding of adenomatous polyp with bleeding
Specialty: GastroenterologyRequired Elements
- Polyp type
- Location
- Presence of bleeding
- Procedure performed
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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