ICD-10 Coding for History of Polyps(Z86.010, Z83.710)
Complete ICD-10-CM coding and documentation guide for History of Polyps. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Polyps
Z86.01-Z86.019Primary Range
Personal history of colonic polyps
This range includes codes for personal history of different types of colonic polyps, crucial for follow-up and surveillance coding.
Family history of colonic polyps
This range covers family history of colonic polyps, important for risk assessment and screening decisions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z86.010 | Personal history of colonic polyps | Use for patients with a history of adenomatous or serrated polyps post-polypectomy. |
|
| Z83.710 | Family history of adenomatous polyps | Use for patients with a documented family history of adenomatous or serrated 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 history of polyps
Essential facts and insights about History of Polyps
Primary ICD-10-CM Codes for history of polyps
Decision Criteria
clinical Criteria
- Patient has a documented history of adenomatous or serrated polyps.
coding Criteria
- Do not use for current polyps.
Applicable To
- Adenomatous polyps
- Serrated polyps
Excludes
- Current polyps (K63.5)
Clinical Validation Requirements
- Pathology report confirming adenomatous or serrated polyps
- Documentation of previous polypectomy
Code-Specific Risks
- Incorrectly using for current polyps
- Not specifying polyp type
Coding Notes
- Ensure documentation specifies the type of polyp for accurate coding.
Z83.710 - Family history of adenomatous polyps
Use for patients with a documented family history of adenomatous or serrated polyps.
Applicable To
- Family history of serrated polyps
Excludes
- Personal history of polyps (Z86.010)
Clinical Validation Requirements
- Family history documented in medical records
- Specific relation and type of polyp noted
Coding Notes
Ensure family history is clearly documented to support high-risk screening coding.
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 History of Polyps to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.010.
Impact
Clinical: Leads to inadequate patient management., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to unspecified coding.
Mitigation Strategy
Use templates for documentation, Regular training on coding updates
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient history records.
Mitigation Strategy
Use K63.5 for current polyps and Z86.010 for history.
Impact
Reimbursement: May affect risk stratification and billing., Compliance: Fails to meet documentation standards., Data Quality: Leads to incomplete patient records.
Mitigation Strategy
Query provider for specific polyp type if not documented.
Impact
Using history codes for current conditions.
Mitigation Strategy
Regular audits and coder training.
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 History of Polyps, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Polyps
Use these documentation templates to ensure complete and accurate documentation for History of Polyps. These templates include all required elements for proper coding and billing.
Surveillance Colonoscopy
Specialty: GastroenterologyRequired Elements
- Patient history
- Polyp type
- Previous procedures
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for History of Polyps? Ask your questions below.