ICD-10 Coding for Rectal Polyp(K62.1, D12.8)
Complete ICD-10-CM coding and documentation guide for Rectal Polyp. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Rectal 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 |
|---|---|---|---|
| K62.1 | Rectal polyp | Use for non-neoplastic polyps, especially hyperplastic or unspecified types. |
|
| D12.8 | Benign neoplasm of rectum | Use when biopsy confirms 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 rectal polyp
Essential facts and insights about Rectal Polyp
Primary ICD-10-CM Codes for rectal polyp
Decision Criteria
clinical Criteria
- Polyp is described as hyperplastic or unspecified without adenomatous features.
Applicable To
- Hyperplastic rectal polyp
- Unspecified rectal polyp
Excludes
- Adenomatous polyp (D12.8)
Clinical Validation Requirements
- Procedure note stating 'hyperplastic'
- No adenomatous features on biopsy
Code-Specific Risks
- Incorrect use for adenomatous polyps
Coding Notes
- Ensure pathology reports are reviewed to confirm polyp type.
D12.8 - Benign neoplasm of rectum
Use when biopsy confirms adenomatous features.
Applicable To
- Adenomatous rectal polyp
- Tubular adenoma
Excludes
- Hyperplastic polyp (K62.1)
Clinical Validation Requirements
- Pathology report confirming adenomatous features
Coding Notes
Ensure biopsy results are documented in the patient's record.
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 Rectal Polyp to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K62.1.
Impact
Clinical: Inaccurate clinical data for patient management., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Ensure procedure notes include polyp type and size., Review pathology reports for confirmation.
Impact
Reimbursement: May lead to claim denials or incorrect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use D12.8 when biopsy confirms adenomatous features.
Impact
Reimbursement: Potential underpayment due to incomplete coding., Compliance: Failure to capture risk factors., Data Quality: Incomplete patient history documentation.
Mitigation Strategy
Include Z83.71_ when family history of polyps is documented.
Impact
Using D12.8 without biopsy confirmation.
Mitigation Strategy
Ensure pathology reports are reviewed and documented.
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 Rectal Polyp, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Rectal Polyp
Use these documentation templates to ensure complete and accurate documentation for Rectal Polyp. These templates include all required elements for proper coding and billing.
Colonoscopy with polyp removal
Specialty: GastroenterologyRequired Elements
- Polyp size and location
- Type of polyp (hyperplastic, adenomatous)
- Procedure performed
- Pathology results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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