ICD-10 Coding for Duodenal Polyp(K31.7, D13.1)
Complete ICD-10-CM coding and documentation guide for Duodenal Polyp. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Duodenal Polyp
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K31.7 | Polyp of stomach and duodenum | Use for non-neoplastic polyps such as hyperplastic, inflammatory, or hamartomatous polyps. |
|
| D13.1 | Benign neoplasm of duodenum | Use for adenomatous or neoplastic 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 duodenal polyp
Essential facts and insights about Duodenal Polyp
Primary ICD-10-CM Codes for duodenal polyp
Decision Criteria
clinical Criteria
- Histology confirms non-neoplastic nature
coding Criteria
- Polyp size and morphology documented
Applicable To
- Non-neoplastic duodenal polyps
Excludes
- Adenomatous polyp of stomach (D13.1)
Clinical Validation Requirements
- Endoscopic findings of small (<1 cm), sessile lesions without dysplasia on histology
Code-Specific Risks
- Misclassification of adenomatous polyps as non-neoplastic
Coding Notes
- Ensure histological confirmation to differentiate between non-neoplastic and adenomatous polyps.
D13.1 - Benign neoplasm of duodenum
Use for adenomatous or neoplastic polyps.
Applicable To
- Adenomatous duodenal polyps
Clinical Validation Requirements
- Histology showing tubular/villous architecture, dysplasia
Coding Notes
Ensure documentation of adenomatous features and any associated syndromes.
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 Duodenal Polyp to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K31.7.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure histology is documented in the medical record.
Impact
Reimbursement: Incorrect coding may lead to reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Affects accuracy of medical records.
Mitigation Strategy
Use D13.1 for adenomatous polyps.
Impact
Lack of detailed histology can lead to audit issues.
Mitigation Strategy
Ensure all histological findings are documented.
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 Duodenal Polyp, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Duodenal Polyp
Use these documentation templates to ensure complete and accurate documentation for Duodenal Polyp. These templates include all required elements for proper coding and billing.
Endoscopic removal of duodenal polyp
Specialty: GastroenterologyRequired Elements
- Polyp size
- Location in duodenum
- Morphology
- Removal technique
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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