ICD-10 Coding for Colonic Polyp(D12.6, K63.5)
Complete ICD-10-CM coding and documentation guide for Colonic Polyp. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Colonic Polyp
D12.0-D12.9Primary Range
Benign neoplasm of colon, rectum, anus and anal canal
This range covers adenomatous polyps, which are common types of colonic 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 |
|---|---|---|---|
| D12.6 | Benign neoplasm of colon, unspecified | Use when pathology confirms adenomatous polyp in the colon. |
|
| K63.5 | Polyp of colon | Use when the polyp is identified as hyperplastic. |
|
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 colonic polyp
Essential facts and insights about Colonic Polyp
Primary ICD-10-CM Codes for colonic polyp
Decision Criteria
clinical Criteria
- Histology confirms adenomatous polyp
Applicable To
- Adenomatous polyp of colon
Excludes
- Hyperplastic polyp of colon (K63.5)
Clinical Validation Requirements
- Pathology report confirming adenomatous histology
Code-Specific Risks
- Misclassification if histology is not confirmed
Coding Notes
- Ensure histological confirmation before coding as adenomatous.
K63.5 - Polyp of colon
Use when the polyp is identified as hyperplastic.
Applicable To
- Hyperplastic polyp of colon
Excludes
- Adenomatous polyp of colon (D12.6)
Clinical Validation Requirements
- Endoscopic findings consistent with hyperplastic polyp
Coding Notes
Do not use for adenomatous polyps.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Colonic Polyp to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D12.6.
Impact
Clinical: Inadequate information for risk assessment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Always document polyp size in millimeters.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Impacts accuracy of medical records.
Mitigation Strategy
Ensure histological confirmation before coding as adenomatous (D12.x).
Impact
Lack of histology confirmation for adenomatous polyps.
Mitigation Strategy
Require pathology reports for all polyp removals.
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 Polyp, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Colonic Polyp
Use these documentation templates to ensure complete and accurate documentation for Colonic Polyp. These templates include all required elements for proper coding and billing.
Screening Colonoscopy with Polyp Removal
Specialty: GastroenterologyRequired Elements
- Indication for procedure
- Findings including polyp size and location
- Histology results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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