ICD-10 Coding for Colorectal Cancer(C18.2, C19)
Complete ICD-10-CM coding and documentation guide for Colorectal Cancer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Colorectal Cancer
C18-C20Primary Range
Malignant neoplasms of colon, rectosigmoid junction, and rectum
This range covers primary malignant neoplasms of the colon and rectum, which are the main focus of colorectal cancer diagnosis.
Secondary malignant neoplasms of digestive organs
These codes are used for metastases to the colon or rectum from other primary sites.
Encounter for screening for malignant neoplasm of colon
Used for screening procedures aimed at detecting colorectal cancer in asymptomatic patients.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C18.2 | Malignant neoplasm of ascending colon | Use when the primary site of cancer is confirmed to be the ascending colon. |
|
| C19 | Malignant neoplasm of rectosigmoid junction | Use when cancer is located at the rectosigmoid junction. |
|
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 colorectal cancer
Essential facts and insights about Colorectal Cancer
Primary ICD-10-CM Codes for colorectal cancer
Decision Criteria
clinical Criteria
- Confirmed diagnosis of cancer in the ascending colon
Applicable To
- Cancer of the ascending colon
Excludes
- Benign neoplasms of the colon (D12.2)
Clinical Validation Requirements
- Histopathological confirmation of adenocarcinoma
- Imaging studies showing mass in ascending colon
Code-Specific Risks
- Misclassification if the site is not clearly documented
Coding Notes
- Ensure documentation specifies the exact location within the colon.
C19 - Malignant neoplasm of rectosigmoid junction
Use when cancer is located at the rectosigmoid junction.
Applicable To
- Cancer of the rectosigmoid junction
Excludes
- Benign neoplasms of the rectosigmoid junction (D12.3)
Clinical Validation Requirements
- Biopsy confirming adenocarcinoma
- Colonoscopy findings
Coding Notes
Document the precise location to avoid coding errors.
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 Colorectal Cancer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C18.2.
Impact
Clinical: Missed opportunities for early screening in relatives, Regulatory: Non-compliance with documentation standards, Financial: Potential loss of reimbursement for high-risk screenings
Mitigation Strategy
Always ask about family history during patient intake, Document any family history in the patient's medical record
Impact
Reimbursement: May result in incorrect DRG assignment and reimbursement, Compliance: Non-compliance with coding guidelines, Data Quality: Decreased accuracy in cancer registry data
Mitigation Strategy
Use the specific site code (e.g., C18.2 for ascending colon) when available.
Impact
Inadequate documentation of screening intent can lead to audits.
Mitigation Strategy
Ensure clear documentation of screening vs. diagnostic intent in medical records.
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 Colorectal Cancer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Colorectal Cancer
Use these documentation templates to ensure complete and accurate documentation for Colorectal Cancer. These templates include all required elements for proper coding and billing.
Routine Screening Colonoscopy
Specialty: GastroenterologyRequired Elements
- Indication for procedure
- Findings and interventions
- Biopsy results if applicable
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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