ICD-10 Coding for Fundic Gland Polyp(K31.7, D12.91)
Complete ICD-10-CM coding and documentation guide for Fundic Gland Polyp. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fundic Gland Polyp
K31-K31.9Primary Range
Diseases of the stomach and duodenum
This range includes codes for various stomach and duodenal conditions, including fundic gland polyps.
Benign neoplasm of colon, rectum, anus, and anal canal
This range includes codes for familial adenomatous polyposis, which can be associated with fundic gland polyps.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K31.7 | Polyp of stomach and duodenum | Use for sporadic fundic gland polyps, especially in patients with a history of PPI use. |
|
| D12.91 | Benign neoplasm of unspecified site of digestive system | Use for fundic gland polyps associated with familial adenomatous polyposis. |
|
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 fundic gland polyp
Essential facts and insights about Fundic Gland Polyp
Primary ICD-10-CM Codes for fundic gland polyp
Decision Criteria
clinical Criteria
- Patient has multiple small sessile polyps in the gastric fundus.
documentation Criteria
- Biopsy confirms cystic dilatation without dysplasia.
Applicable To
- Fundic gland polyp
Excludes
- Hyperplastic polyp of stomach (K31.70)
Clinical Validation Requirements
- Endoscopic findings of sessile polyps in the gastric fundus
- Biopsy showing cystically dilated glands lined by parietal cells
- Negative H. pylori status
Code-Specific Risks
- Confusion with hyperplastic polyps
- Failure to document PPI use
Coding Notes
- Ensure documentation includes PPI use and biopsy findings to support the use of K31.7.
D12.91 - Benign neoplasm of unspecified site of digestive system
Use for fundic gland polyps associated with familial adenomatous polyposis.
Applicable To
- Familial adenomatous polyposis
Clinical Validation Requirements
- Genetic testing confirming APC mutation
- Family history of FAP
Coding Notes
Ensure genetic testing and family history are documented to support the use of D12.91.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Hyperplastic polyp of stomach
K31.70Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Fundic Gland Polyp to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K31.7.
Impact
Clinical: May lead to misclassification of polyp type., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Ensure medication history is reviewed and documented, Include PPI use in clinical notes
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Misclassification affects data accuracy., Data Quality: Inaccurate coding impacts clinical data integrity.
Mitigation Strategy
Verify biopsy findings and H. pylori status to differentiate.
Impact
Inadequate documentation of PPI use can lead to audit findings.
Mitigation Strategy
Implement checklist for medication history documentation.
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 Fundic Gland Polyp, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fundic Gland Polyp
Use these documentation templates to ensure complete and accurate documentation for Fundic Gland Polyp. These templates include all required elements for proper coding and billing.
Sporadic Fundic Gland Polyp in PPI User
Specialty: GastroenterologyRequired Elements
- Number and size of polyps
- Biopsy findings
- PPI use history
- H. pylori status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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