ICD-10 Coding for Colon Polyp(D12.0, K63.5)
Complete ICD-10-CM coding and documentation guide for Colon Polyp. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Colon Polyp
D12.0-D12.8Primary Range
Benign neoplasm of colon, rectum, anus and anal canal
Used for adenomatous polyps based on location within the colon
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 an adenomatous polyp is located in the cecum |
|
| K63.5 | Polyp of colon | Use for hyperplastic or unspecified polyps |
|
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 adenomatous colon polyp
Essential facts and insights about Colon Polyp
Primary ICD-10-CM Codes for colon polyp
Decision Criteria
clinical Criteria
- Adenomatous tissue confirmed by pathology
Applicable To
- Adenomatous polyp of cecum
Excludes
- Malignant neoplasm of cecum
Clinical Validation Requirements
- Pathology report confirming adenomatous tissue
Code-Specific Risks
- Incorrect use for hyperplastic polyps
Coding Notes
- Ensure pathology confirms adenomatous nature before coding
K63.5 - Polyp of colon
Use for hyperplastic or unspecified polyps
Applicable To
- Hyperplastic polyp of colon
Excludes
- Adenomatous polyp of colon
Clinical Validation Requirements
- Endoscopic findings of hyperplastic morphology
Coding Notes
Ensure documentation specifies hyperplastic nature
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 Colon 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: Inaccurate clinical records, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials
Mitigation Strategy
Ensure pathology reports are reviewed and included, Use templates that prompt for polyp type
Impact
Reimbursement: Incorrect coding may lead to claim denials, Compliance: Non-compliance with ICD-10 guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Use D12.x codes for adenomatous polyps based on location
Impact
Coding hyperplastic polyps as adenomatous
Mitigation Strategy
Review pathology reports before coding
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 expert answers to help guide accurate code selection and documentation.
Documentation Templates for Colon Polyp
Use these documentation templates to ensure complete and accurate documentation for Colon Polyp. These templates include all required elements for proper coding and billing.
Colonoscopy with polyp removal
Specialty: GastroenterologyRequired Elements
- Polyp location
- Polyp size
- Polyp morphology
- Excision method
- Pathology results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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