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v1.0.0
ICD-10 Guide
ICD-10 CodesD12.3

D12.3

Billable

Benign neoplasm of transverse colon

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

Code Description

ICD-10 D12.3 is a billable code used to indicate a diagnosis of benign neoplasm of transverse colon.

Key Diagnostic Point:

A benign neoplasm of the transverse colon refers to a non-cancerous tumor that arises from the tissues of the transverse colon, which is the part of the large intestine that crosses the abdomen from right to left. These neoplasms can include adenomas, hyperplastic polyps, and other benign growths. While benign, these neoplasms can still pose clinical significance, as they may lead to symptoms such as abdominal pain, obstruction, or changes in bowel habits. Surveillance is often recommended to monitor for any changes in size or characteristics that could indicate a risk of malignant transformation. The management of benign neoplasms typically involves regular colonoscopic surveillance, especially if the neoplasm is large or has dysplastic features. The risk of malignant potential varies depending on the type of neoplasm, with adenomatous polyps having a higher risk of progression to colorectal cancer compared to hyperplastic polyps. Therefore, appropriate coding and documentation are essential for ensuring proper management and follow-up care.

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 protocols
  • Variability in clinical presentation and management

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed descriptions of the neoplasm type, size, and any dysplastic features observed during colonoscopy.

Common Clinical Scenarios

Patients presenting with abdominal pain, rectal bleeding, or incidental findings during routine colonoscopy.

Billing Considerations

Ensure that surveillance intervals are documented, especially if the neoplasm has characteristics that warrant closer monitoring.

Pathology

Documentation Requirements

Histopathological reports detailing the type of neoplasm and any relevant findings.

Common Clinical Scenarios

Pathological evaluation of biopsy specimens from colonoscopic procedures.

Billing Considerations

Accurate reporting of findings is crucial for determining the appropriate coding and follow-up care.

Coding Guidelines

Inclusion Criteria

Use D12.3 When
  • According to ICD
  • 10 coding guidelines, D12
  • 3 should be used when a benign neoplasm of the transverse colon is confirmed through diagnostic imaging or histopathological examination
  • It is essential to document the type of neoplasm and any relevant clinical findings to support the diagnosis

Exclusion Criteria

Do NOT use D12.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

45378CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used for surveillance of benign neoplasms in the transverse colon.

Documentation Requirements

Document findings, size, and type of neoplasm.

Specialty Considerations

Gastroenterologists should ensure that surveillance intervals are clearly noted.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding benign neoplasms, improving the accuracy of patient records and facilitating better management strategies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding benign neoplasms, improving the accuracy of patient records and facilitating better management strategies.

Reimbursement & Billing Impact

reimbursement.

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 benign neoplasms?

Accurate coding of benign neoplasms is crucial for appropriate management and surveillance, as it helps healthcare providers monitor potential risks and ensures proper reimbursement for services rendered.