ICD-10 Coding for Gastric Polyp(K31.7, D13.1)
Complete ICD-10-CM coding and documentation guide for Gastric Polyp. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Gastric Polyp
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 non-neoplastic gastric polyps unless histology confirms neoplasia. |
|
| D13.1 | Benign neoplasm of stomach | Use when biopsy confirms adenomatous or neoplastic nature of the 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 gastric polyp
Essential facts and insights about Gastric Polyp
Primary ICD-10-CM Codes for gastric polyp
Decision Criteria
clinical Criteria
- Endoscopic identification of a gastric polyp
documentation Criteria
- Histology report confirming non-neoplastic nature
Applicable To
- Hyperplastic gastric polyp
- Inflammatory gastric polyp
Clinical Validation Requirements
- Endoscopic findings of polyp
- Histology confirming non-neoplastic nature
Code-Specific Risks
- Incorrectly coding neoplastic polyps under K31.7
Coding Notes
- Ensure histology results are reviewed to confirm non-neoplastic nature before using K31.7.
D13.1 - Benign neoplasm of stomach
Use when biopsy confirms adenomatous or neoplastic nature of the polyp.
Applicable To
- Adenomatous gastric polyp
Excludes
- Malignant neoplasm of stomach (C16.9)
Clinical Validation Requirements
- Biopsy confirming adenomatous nature
- Pathology report indicating benign neoplasm
Coding Notes
Ensure biopsy results confirm adenomatous nature before using D13.1.
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 Gastric 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: Leads to potential misdiagnosis., Regulatory: Non-compliance with documentation standards., Financial: May result in denied claims.
Mitigation Strategy
Ensure detailed endoscopy reports., Verify histology results before coding.
Impact
Reimbursement: Incorrect coding may lead to reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Review biopsy results to confirm the nature of the polyp before coding.
Impact
Coding without histology confirmation can lead to audit issues.
Mitigation Strategy
Ensure all polyps are biopsied and histology results 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 Gastric Polyp, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Gastric Polyp
Use these documentation templates to ensure complete and accurate documentation for Gastric Polyp. These templates include all required elements for proper coding and billing.
Screening EGD with incidental polyp
Specialty: GastroenterologyRequired Elements
- Indication for procedure
- Polyp location and size
- Removal technique
- Histology results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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