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Adenomatous Polyp with Dysplasia

Heidi Posted Wed 12th of October, 2016 11:26:02 AM
For insurance purposes to recognize the patient is high risk and would need procedures every 5 years, how would you bill the following: "ADENOMATOUS POLYP OF DISTAL SIGMOID COLON WITH MODERATE SURFACE DYSPLASIA." Would you just bill D37.4 to specify the Dysplasia part, OR would you bill D12.5 and D37.4 to show the polyp and the Dysplasia? I don't see any exclusion notes on those that says you can't bill them together, but I wanted to double check what is the right way to bill that Adenomatous Sigmoid polyp with Dysplasia. Thank you!!
SuperCoder Answered Thu 13th of October, 2016 04:24:28 AM

Hi,

The appropriate ICD 10 CM code for ADENOMATOUS POLYP OF DISTAL SIGMOID COLON WITH MODERATE SURFACE DYSPLASIA is D12.5 only. ICD D37.4 will not be coded as it is used for Neoplasm of uncertain behavior of colon. By defination dysplasia is the enlargement of an organ or tissue by the proliferation of cells of an abnormal type, as a developmental disorder or an early stage in the development of cancer. Dysplasia is sign and symptom of cancer which is included in ICD D12.5.

Thanks

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