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ICD-10 Guide
ICD-10 CodesD12.4

D12.4

Billable

Benign neoplasm of descending colon

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D12.4 is a billable code used to indicate a diagnosis of benign neoplasm of descending colon.

Key Diagnostic Point:

A benign neoplasm of the descending colon refers to a non-cancerous tumor that arises from the tissues of the descending colon, which is part of the large intestine. These neoplasms can vary in size and may be asymptomatic or cause symptoms such as abdominal pain, changes in bowel habits, or rectal bleeding. Common types of benign neoplasms in this region include adenomatous polyps, hyperplastic polyps, and lipomas. While benign, these neoplasms require careful monitoring as some types, particularly adenomatous polyps, have the potential to progress to colorectal cancer over time. Surveillance colonoscopy is often recommended to monitor for changes in size or number of polyps, and to remove any that may pose a risk of malignancy. The management of benign neoplasms typically involves regular follow-up and may include polypectomy during colonoscopy if indicated. Understanding the nature of these neoplasms is crucial for appropriate coding and patient management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between benign and malignant neoplasms
  • Understanding the specific type of benign neoplasm
  • Documentation of surveillance and follow-up care
  • Potential for progression to malignancy requiring careful monitoring

Audit Risk Factors

  • Inadequate documentation of the type of neoplasm
  • Failure to document surveillance recommendations
  • Misclassification of benign neoplasm as malignant
  • Lack of follow-up notes or colonoscopy results

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed descriptions of the neoplasm type, size, and any symptoms; results of colonoscopy and biopsy if performed.

Common Clinical Scenarios

Routine surveillance colonoscopy for patients with a history of polyps; management of symptomatic benign neoplasms.

Billing Considerations

Ensure that all findings from colonoscopy are documented, including any interventions performed.

Pathology

Documentation Requirements

Histopathological reports detailing the nature of the neoplasm, including type and any dysplastic changes.

Common Clinical Scenarios

Reviewing biopsy specimens from colonoscopy; providing diagnostic confirmation of benign neoplasms.

Billing Considerations

Accurate coding based on histological findings is crucial for proper billing and patient management.

Coding Guidelines

Inclusion Criteria

Use D12.4 When
  • According to ICD
  • 10 coding guidelines, D12
  • 4 should be used when a benign neoplasm of the descending colon is confirmed through diagnostic imaging or biopsy
  • It is important to document the specific type of neoplasm and any associated symptoms or treatments

Exclusion Criteria

Do NOT use D12.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

45385CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used for surveillance of known benign neoplasms.

Documentation Requirements

Document findings, any biopsies taken, and recommendations for follow-up.

Specialty Considerations

Gastroenterologists should ensure that all findings are clearly documented to support the diagnosis code.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of benign neoplasms, improving the accuracy of patient records and facilitating better tracking of surveillance needs and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of benign neoplasms, improving the accuracy of patient records and facilitating better tracking of surveillance needs and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of benign neoplasms, improving the accuracy of patient records and facilitating better tracking of surveillance needs and outcomes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding D12.4?

Coding D12.4 accurately reflects the presence of a benign neoplasm in the descending colon, which is important for patient management and surveillance. It helps in tracking the patient's history and ensuring appropriate follow-up care.