ICD-10 Coding for Polypectomy(D12.0, K63.5)
Complete ICD-10-CM coding and documentation guide for Polypectomy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Polypectomy
D12-D12.9Primary Range
Benign neoplasm of colon, rectum, anus
Primary range for adenomatous polyps, which are common targets for polypectomy.
Encounter for screening for malignant neoplasm of colon
Used for screening colonoscopies where polyps are found.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D12.0 | Benign neoplasm of cecum | Use when a benign adenomatous polyp is confirmed in the cecum. |
|
| K63.5 | Polyp of colon | Use for polyps identified as hyperplastic 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 polypectomy
Essential facts and insights about Polypectomy
Primary ICD-10-CM Codes for polypectomy
Decision Criteria
clinical Criteria
- Pathology confirms adenomatous polyp
Applicable To
- Adenomatous polyp of cecum
Excludes
- Malignant neoplasm of cecum
Clinical Validation Requirements
- Pathology report confirming adenomatous polyp
Code-Specific Risks
- Incorrectly coding malignant neoplasms as benign.
Coding Notes
- Ensure pathology confirms adenomatous nature before using D12 codes.
K63.5 - Polyp of colon
Use for polyps identified as hyperplastic without adenomatous features.
Applicable To
- Hyperplastic polyp of colon
Excludes
- Adenomatous polyp of colon
Clinical Validation Requirements
- Endoscopic findings of hyperplastic polyp
Coding Notes
Ensure documentation specifies the polyp type as hyperplastic.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for screening for malignant neoplasm of colon
Z12.11Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Polypectomy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D12.0.
Impact
Clinical: Leads to inaccurate clinical records., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Train staff on documentation requirements, Use templates
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Use D12.x codes for adenomatous polyps confirmed by pathology.
Impact
Risk of coding hyperplastic polyps as adenomatous.
Mitigation Strategy
Ensure pathology confirmation 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 Polypectomy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Polypectomy
Use these documentation templates to ensure complete and accurate documentation for Polypectomy. These templates include all required elements for proper coding and billing.
Colonoscopy with Polypectomy
Specialty: GastroenterologyRequired Elements
- Procedure type
- Polyp size and location
- Resection method
- Pathology pending
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Polypectomy? Ask your questions below.