ICD-10 Coding for Polyp of Colon(D12.2, K63.5)
Complete ICD-10-CM coding and documentation guide for Polyp of Colon. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Polyp of Colon
D12-D12.9Primary Range
Benign neoplasm of colon, rectum, anus and anal canal
This range includes codes for adenomatous polyps based on their location in the colon.
Polyp of colon
Used for hyperplastic or unspecified polyps when adenomatous features are not present.
Inflammatory polyps associated with ulcerative colitis
Used when polyps are part of ulcerative colitis with complications.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D12.2 | Benign neoplasm of cecum | Use when an adenomatous polyp is confirmed in the cecum. |
|
| K63.5 | Polyp of colon | Use when the polyp is hyperplastic or unspecified without adenomatous features. |
|
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 polyp of colon
Essential facts and insights about Polyp of Colon
Primary ICD-10-CM Codes for polyp of colon
Decision Criteria
clinical Criteria
- Histology confirms adenomatous polyp in the cecum.
Applicable To
- Adenomatous polyp of cecum
Excludes
- Hyperplastic polyp of cecum
Clinical Validation Requirements
- Pathology report confirming adenomatous tissue
- Colonoscopy findings specifying location
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 hyperplastic or unspecified without adenomatous features.
Applicable To
- Hyperplastic polyp of colon
Excludes
- Adenomatous polyp of colon
Clinical Validation Requirements
- Colonoscopy report indicating hyperplastic polyp
- No adenomatous features present
Coding Notes
Do not use with D12.x codes if adenomatous tissue is present.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Polyp of Colon to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D12.2.
Impact
Clinical: Leads to inaccurate diagnosis records., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Train staff on documentation standards, Use templates for consistency
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure histology confirms the type of polyp before coding.
Impact
Coding hyperplastic polyps as adenomatous.
Mitigation Strategy
Ensure histology reports are reviewed before coding.
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 Polyp of Colon, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Polyp of Colon
Use these documentation templates to ensure complete and accurate documentation for Polyp of Colon. These templates include all required elements for proper coding and billing.
Colonoscopy with Polyp Removal
Specialty: GastroenterologyRequired Elements
- Location of polyp
- Size and morphology
- Technique used for removal
- Pathology results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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