2025 ICD-10-CM code D12.6
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Neoplasms - Benign neoplasms of the colon Chapter II: Neoplasms Feed
Benign neoplasm of the colon, unspecified; a noncancerous growth in an unspecified part of the colon.
No specific modifiers directly apply to D12.6 as this is a diagnosis code.However, modifiers may be needed for the procedures used in diagnosis or treatment.
Medical necessity for code D12.6 is established through the clinical presentation (e.g., symptoms, abnormal screening test results) and diagnostic confirmation of the benign colonic neoplasm.The need for further intervention (e.g., surgery, surveillance) depends on the size, characteristics, and associated symptoms.
The clinical responsibility for code D12.6 includes a thorough patient history, physical examination, and ordering appropriate diagnostic tests like colonoscopy, CT, or MRI.The physician may perform or interpret these tests.If surgery is required, the surgeon is responsible for its execution.Pathologists analyze any biopsy specimens.Follow-up care is also under the physician's purview.
In simple words: This code means a non-cancerous growth (benign tumor) has been found in the large intestine (colon), but the exact location within the colon isn't known.It's a mass of abnormal cells that won't spread to other parts of the body. Doctors might use tests like a colonoscopy to check it out and decide if treatment is needed.
D12.6, Benign neoplasm of colon, unspecified, refers to a noncancerous (benign) tumor located in an unspecified part of the large intestine (colon).This code is applied when the specific location within the colon is unknown or not specified by the physician. The tumor is a mass of abnormal cells that do not have the capacity to invade nearby tissues or metastasize (spread to distant sites).Potential causes include genetic predisposition, inflammatory bowel disease, polyps, lifestyle factors (e.g., diet, physical activity), and environmental exposures (e.g., smoking). Diagnosis typically involves clinical evaluation, imaging studies (e.g., colonoscopy, CT scan, MRI), and potentially biopsy for histopathological analysis. Treatment options range from observation to surgical removal, depending on the size, location, and symptoms.
Example 1: A 60-year-old male presents with intermittent abdominal discomfort and a positive fecal occult blood test.Colonoscopy reveals a small, sessile polyp in the unspecified portion of the colon. Biopsy confirms a benign adenoma.Code D12.6 is assigned., A 45-year-old female undergoes routine colonoscopy screening and shows multiple small, non-pedunculated adenomas throughout the colon.The specific location of each lesion isn't documented. The physician assigns code D12.6 to reflect the benign nature and unspecified location., A 72-year-old presents with changes in bowel habits.Imaging reveals a mass in the colon, but the exact anatomical location can’t be determined from the imaging alone. Following a biopsy, the mass is confirmed to be benign. The attending physician selects code D12.6 given the unspecified location.
Patient history detailing symptoms (e.g., abdominal pain, changes in bowel habits, bleeding), physical examination findings, results of diagnostic imaging (e.g., colonoscopy, CT scan, MRI), and pathology report confirming the benign nature of the neoplasm and its histopathological type.
** Always cross-reference with the official ICD-10-CM guidelines and the Table of Neoplasms for the most accurate coding.If a polyp is identified, it's important to differentiate between benign and malignant or premalignant lesions.
- Revenue Code: Further information required to determine appropriate revenue codes based on the specific services rendered.
- RVU: RVUs will vary based on the complexity of the diagnosis and treatment rendered.Information from a specific fee schedule or Relative Value Unit database is required to determine the accurate RVUs for this code.
- Global Days: Not applicable; this is a diagnosis code, not a procedure code.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Not applicable.
- Specialties:Gastroenterology, Colon and Rectal Surgery, Oncology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center