2025 ICD-10-CM code K63.5
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the digestive system - Other diseases of intestines XI Diseases of the digestive system Feed
Polyp of the colon.This code is used to report the presence of a polyp in the colon.
Medical necessity for coding K63.5 is established when a polyp is found in the colon. Colonoscopies for polyp detection are medically necessary for screening (based on age and risk factors), diagnosis of symptoms (e.g., rectal bleeding, changes in bowel habits), or surveillance following previous polyp removal.The specific medical reason should be documented.
The clinical responsibility for coding K63.5 rests with the physician or qualified healthcare professional who performs the colonoscopy or other procedure that reveals the presence of the polyp.They are responsible for accurate documentation of the polyp's characteristics, location, and any other relevant clinical findings.
In simple words: This code means a doctor found a polyp (a small growth) in your colon (the large intestine).More information might be needed about the type of polyp for accurate billing.
K63.5, Polyp of colon, is an ICD-10-CM code used to classify the presence of a polyp within the colon.This code encompasses various types of polyps, excluding specific types such as adenomatous polyps (coded elsewhere), inflammatory polyps, and polyposis.Appropriate documentation should specify the location and characteristics of the polyp(s) if known, and further specify the type of polyp where possible for increased coding accuracy. The absence of specific polyp type information defaults to hyperplastic polyps.
Example 1: A 55-year-old patient undergoes a routine colonoscopy, revealing a single, small hyperplastic polyp in the sigmoid colon.The polyp is removed during the procedure. K63.5 is assigned., A 62-year-old patient presents with symptoms of rectal bleeding. A colonoscopy reveals multiple polyps of varying sizes in the transverse and descending colon. Biopsies are taken, which show one to be adenomatous.K63.5 is used for the non-adenomatous polyps; separate codes would be necessary to address the adenomatous polyp., A 70-year-old patient with a history of inflammatory bowel disease undergoes a colonoscopy.Several inflammatory polyps are found. Note that K63.5 would not apply in this instance due to the existing inflammatory nature of the polyps.
Complete and accurate documentation is crucial for appropriate coding. This includes the patient's medical history, reason for the procedure (e.g., screening, symptoms), procedure report detailing the location, size, number, and type of polyp(s) identified, and pathology report if biopsies were performed.Images from the colonoscopy are also helpful supporting documentation.
** Always refer to the most current ICD-10-CM coding guidelines for the most accurate and up-to-date information.
- Payment Status: Active
- Specialties:Gastroenterology, Colorectal Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient and Outpatient)