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Colonoscopy Diagnosis Coding

Stephanie Posted Tue 10th of September, 2019 19:56:22 PM
Hello, I would like to confirm two things regarding how to code a diagnosis for colon polyps. 1. If the provider is specific as to the location of a polyp removal in his findings; 90mm polyp remove by snare, but only states Colon polyp under is Endoscopic Diagnosis. Should I use ICD-10 K63.5 or D12.3? 2. Is a pathology report required before placing a diagnosis on the colonoscopy charges?
SuperCoder Answered Wed 11th of September, 2019 04:40:06 AM

Hi Stephanie,

 

There are multiple diagnosis codes for removal of colonic polyp(s) and diagnosis code should be based on the pre-operative and post-operative diagnosis mentioned in the colonoscopy report. Diagnosis mentioned in the pathology report would surely help in identifying the exact diagnosis.

 

Since there are multiple codes, use ICD 10 CM code K63.5 if final diagnosis mentioned is polyp of colon. Use K51.4 if final diagnosis is inflammatory polyp of colon. You can use other codes as well as per the final diagnosis mentioned in the colonoscopy report and pathology report.

 

ICD-10 CM code D12.3 is specific to benign neoplasm of transverse colon. If your pathology specimen report indicates that benign neoplasm of transverse colon was identified. You should report the neoplasm specific code.    

 

Thanks!  

   

Stephanie Posted Wed 11th of September, 2019 12:23:42 PM
Thank you for assistance. That helps clarify somethings.
SuperCoder Answered Thu 12th of September, 2019 00:45:39 AM

Thank you, happy to help.

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