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v1.0.0
ICD-10 Guide
ICD-10 CodesD12.5

D12.5

Billable

Benign neoplasm of sigmoid colon

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

Code Description

ICD-10 D12.5 is a billable code used to indicate a diagnosis of benign neoplasm of sigmoid colon.

Key Diagnostic Point:

A benign neoplasm of the sigmoid colon refers to a non-cancerous tumor that arises from the tissues of the sigmoid colon, which is the part of the large intestine closest to the rectum. These neoplasms can vary in size and may be asymptomatic or present with symptoms such as abdominal pain, changes in bowel habits, or rectal bleeding. Common types of benign neoplasms in this area include adenomatous polyps, hyperplastic polyps, and lipomas. While benign, these neoplasms require careful monitoring due to their potential to develop into malignant tumors over time, particularly adenomatous polyps, which can progress to colorectal cancer if left untreated. Surveillance colonoscopy is often recommended for patients with a history of polyps to detect any changes early. The management of benign neoplasms typically involves regular follow-up and, in some cases, surgical intervention if the neoplasm is large or symptomatic.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between benign and malignant neoplasms
  • Understanding the surveillance guidelines for polyps
  • Documentation of size, type, and symptoms associated with the neoplasm
  • Knowledge of related codes for polyps and other gastrointestinal conditions

Audit Risk Factors

  • Inadequate documentation of the neoplasm's characteristics
  • Failure to document surveillance colonoscopy results
  • Misclassification of benign neoplasms as malignant
  • Lack of follow-up documentation for patients with a history of polyps

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed descriptions of the neoplasm, including size, type, and any symptoms.

Common Clinical Scenarios

Patients presenting with abdominal pain or rectal bleeding, or those undergoing surveillance colonoscopy.

Billing Considerations

Ensure accurate coding of polyp types and follow-up recommendations.

Surgery

Documentation Requirements

Operative reports detailing the excision of neoplasms and any histopathological findings.

Common Clinical Scenarios

Surgical removal of large polyps or symptomatic benign neoplasms.

Billing Considerations

Document the rationale for surgical intervention and any findings during the procedure.

Coding Guidelines

Inclusion Criteria

Use D12.5 When
  • According to the official coding guidelines, D12
  • 5 should be used when a benign neoplasm of the sigmoid colon is confirmed through diagnostic imaging or histological examination
  • Coders should ensure that the documentation supports the diagnosis and any associated procedures

Exclusion Criteria

Do NOT use D12.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

45378CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used for surveillance of patients with a history of polyps.

Documentation Requirements

Document findings, including size and type of any neoplasms encountered.

Specialty Considerations

Gastroenterologists should ensure thorough documentation of the procedure and findings.

44160CPT Code

Resection of sigmoid colon

Clinical Scenario

Indicated for large or symptomatic benign neoplasms.

Documentation Requirements

Operative report detailing the procedure and histopathological findings.

Specialty Considerations

Surgeons must document the reason for resection and any complications.

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 data collection and reimbursement processes. D12.5 provides a clear distinction from malignant codes, which is crucial for patient management and surveillance.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of benign neoplasms, improving the accuracy of data collection and reimbursement processes. D12.5 provides a clear distinction from malignant codes, which is crucial for patient management and surveillance.

Reimbursement & Billing Impact

reimbursement processes. D12.5 provides a clear distinction from malignant codes, which is crucial for patient management and surveillance.

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 D12.5?

Coding D12.5 accurately reflects the presence of a benign neoplasm in the sigmoid colon, which is important for appropriate management and surveillance to prevent potential malignant transformation.