ICD-10 Coding for Mass in Colon(C18.9, D12.6, K63.5)
Complete ICD-10-CM coding and documentation guide for Mass in Colon. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mass in Colon
C18-C20Primary Range
Malignant neoplasms of colon, rectosigmoid junction, and rectum
This range includes codes for malignant neoplasms of the colon, which are primary when a mass is confirmed as malignant.
Benign neoplasms of colon, rectum, anus, and anal canal
This range is used for benign neoplasms of the colon, applicable when the mass is confirmed as benign.
Other diseases of intestine
This range includes codes for polyps and other non-neoplastic conditions of the colon.
Other symptoms and signs involving the digestive system and abdomen
This range includes codes for unspecified abdominal masses, used when the mass is not yet specified as colonic.
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 malignancy and the specific site within the colon is not documented. |
|
| D12.6 | Benign neoplasm of colon, unspecified | Use when pathology confirms the mass is benign. |
|
| K63.5 | Polyp of colon | Use when a colonoscopy identifies a polyp. |
|
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 mass in colon
Essential facts and insights about Mass in Colon
Primary ICD-10-CM Codes for mass in colon
Decision Criteria
clinical Criteria
- Biopsy confirms adenocarcinoma
documentation Criteria
- Pathology report states 'malignant'
Applicable To
- Colon cancer
Excludes
- Benign neoplasm of colon (D12.6)
Clinical Validation Requirements
- Biopsy confirming adenocarcinoma
- Imaging showing invasion beyond muscularis propria
Code-Specific Risks
- Incorrect use without biopsy confirmation
Coding Notes
- Ensure malignancy is confirmed before using this code.
D12.6 - Benign neoplasm of colon, unspecified
Use when pathology confirms the mass is benign.
Applicable To
- Benign colon tumor
Excludes
- Malignant neoplasm of colon (C18.9)
Clinical Validation Requirements
- Pathology specifying tubular/villous adenoma
- No lymphovascular invasion noted
Coding Notes
Ensure benign nature is confirmed before using this code.
K63.5 - Polyp of colon
Use when a colonoscopy identifies a polyp.
Applicable To
- Colon polyp
Excludes
- Malignant neoplasm of colon (C18.9)
Clinical Validation Requirements
- Endoscopic findings of polyp
- Pathology confirming hyperplastic polyp
Coding Notes
Ensure polyp type is documented.
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 Mass in Colon 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 inappropriate treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials due to lack of specificity.
Mitigation Strategy
Always specify anatomical location, Use standardized templates
Impact
Reimbursement: May lead to claim denials due to lack of specificity., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Reduces accuracy of health data.
Mitigation Strategy
Use specific codes like C18.9 or D12.6 based on pathology.
Impact
Reimbursement: Incorrect follow-up coding can affect reimbursement., Compliance: Non-compliance with follow-up coding guidelines., Data Quality: Affects longitudinal patient data accuracy.
Mitigation Strategy
Ensure follow-up documentation reflects history of polyp removal.
Impact
Using unspecified codes when specific codes are available.
Mitigation Strategy
Ensure documentation supports the most specific code available.
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 Mass in Colon, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mass in Colon
Use these documentation templates to ensure complete and accurate documentation for Mass in Colon. These templates include all required elements for proper coding and billing.
Colonoscopy with Polyp Detection
Specialty: GastroenterologyRequired Elements
- Location of polyp
- Size and type of polyp
- Biopsy results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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