ICD-10 Coding for Adenomatous Colon Polyp(D12.2, Z86.010)
Complete ICD-10-CM coding and documentation guide for Adenomatous Colon Polyp. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Adenomatous Colon Polyp
D12.0-D12.9Primary Range
Benign neoplasm of colon, rectum, anus
This range includes codes for adenomatous polyps based on their location in the colon.
Personal history of colonic polyps
Used for documenting a personal history of adenomatous polyps.
Encounter for screening for malignant neoplasm of colon
Primary code for screening colonoscopy, even if a polyp is 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 |
|---|---|---|---|
| D12.2 | Benign neoplasm of ascending colon | Use when an adenomatous polyp is confirmed in the ascending colon. |
|
| Z86.010 | Personal history of colonic polyps | Use for documenting a personal history of adenomatous 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: adenomatous colon polyp icd 10
Essential facts and insights about Adenomatous Colon Polyp
Primary ICD-10-CM Codes for adenomatous colon polyp
Decision Criteria
clinical Criteria
- Biopsy confirms adenomatous features in ascending colon.
documentation Criteria
- Documentation specifies 'adenomatous polyp' and 'ascending colon'.
Applicable To
- Adenomatous polyp of ascending colon
Excludes
- Hyperplastic polyp (K63.5)
Clinical Validation Requirements
- Biopsy confirming adenomatous features
- Colonoscopy findings specifying location
Code-Specific Risks
- Misclassification if histology is not confirmed
Coding Notes
- Ensure documentation specifies 'adenomatous' and exact location.
Z86.010 - Personal history of colonic polyps
Use for documenting a personal history of adenomatous polyps.
Applicable To
- History of adenomatous colon polyp
Clinical Validation Requirements
- Patient history indicating prior adenomatous polyp
Coding Notes
Ensure history is clearly documented.
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 Adenomatous Colon Polyp to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D12.2.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Use templates for colonoscopy reports, Verify documentation completeness
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on polyp types.
Mitigation Strategy
Verify histology and use D12.x for adenomatous polyps.
Impact
Using K63.5 without histological confirmation.
Mitigation Strategy
Ensure pathology 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 Adenomatous Colon Polyp, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Adenomatous Colon Polyp
Use these documentation templates to ensure complete and accurate documentation for Adenomatous Colon Polyp. These templates include all required elements for proper coding and billing.
Colonoscopy with polyp removal
Specialty: GastroenterologyRequired Elements
- Polyp size
- Polyp location
- Histology results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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