ICD-10 Coding for Colonic Mass(C18.9, D12.6, K63.5, R19.5)
Complete ICD-10-CM coding and documentation guide for Colonic Mass. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Colonic Mass
C18-C20Primary Range
Malignant neoplasms of colon, rectosigmoid junction, and rectum
Primary range for malignant colonic masses, including adenocarcinoma.
Benign neoplasms of the colon, rectum, anus, and anal canal
Covers benign colonic masses such as adenomas.
Other specified symptoms and signs involving the digestive system and abdomen
Used for unspecified abdominal masses pending further investigation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C18.9 | Malignant neoplasm of colon, unspecified | Use when a biopsy confirms adenocarcinoma in the colon. |
|
| D12.6 | Benign neoplasm of colon, unspecified | Use when histology confirms a benign adenoma. |
|
| K63.5 | Polyp of colon | Use when polyps are identified without histological confirmation. |
|
| R19.5 | Other specified symptoms and signs involving the digestive system and abdomen | Use when a mass is identified but not yet classified. |
|
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 colonic mass
Essential facts and insights about Colonic Mass
Primary ICD-10-CM Codes for colonic mass
Decision Criteria
clinical Criteria
- Biopsy confirms adenocarcinoma
coding Criteria
- Use C18.9 for confirmed malignant neoplasms
Applicable To
- Adenocarcinoma of colon
Excludes
- Benign neoplasms (D12.6)
Clinical Validation Requirements
- Biopsy confirmation of malignancy
- Imaging showing invasion beyond submucosa
Code-Specific Risks
- Misclassification if biopsy results are pending
Coding Notes
- Ensure biopsy results are documented before coding as malignant.
D12.6 - Benign neoplasm of colon, unspecified
Use when histology confirms a benign adenoma.
Applicable To
- Tubular adenoma
Excludes
- Malignant neoplasms (C18.9)
Clinical Validation Requirements
- Histology report specifying adenoma type
Coding Notes
Ensure histology report is available before coding.
K63.5 - Polyp of colon
Use when polyps are identified without histological confirmation.
Applicable To
- Colonic polyp
Excludes
- Malignant neoplasms (C18.9)
Clinical Validation Requirements
- Endoscopic visualization of polyp
Coding Notes
Await histology results for accurate classification.
R19.5 - Other specified symptoms and signs involving the digestive system and abdomen
Use when a mass is identified but not yet classified.
Applicable To
- Abdominal mass
Clinical Validation Requirements
- Imaging showing mass in abdomen
Coding Notes
Follow up with specific diagnosis once available.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Polyp of colon
K63.5Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Colonic Mass to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C18.9.
Impact
Clinical: May lead to incorrect treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure biopsy results are documented before coding., Regular audits of patient records.
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data affecting patient records and treatment plans.
Mitigation Strategy
Code C18.9 for confirmed malignancy and use K63.5 only if polyp morphology coexists.
Impact
Lack of biopsy documentation can lead to audit issues.
Mitigation Strategy
Ensure all biopsy results are documented and coded accurately.
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 Colonic Mass, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Colonic Mass
Use these documentation templates to ensure complete and accurate documentation for Colonic Mass. These templates include all required elements for proper coding and billing.
Colonic Mass Biopsy
Specialty: GastroenterologyRequired Elements
- Mass location
- Size
- Biopsy results
- Imaging findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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