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v1.0.0
ICD-10 Guide
DiagnosesPolypectomy

Polypectomy

ICD-10 Coding for Polypectomy(D12.0, K63.5)

PRIMARY SPECIALTYGastroenterology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Polypectomy?
Essential facts and insights about Polypectomy

Key Clinical Considerations:

  • Presence of polyps in the gastrointestinal tract
  • Colonoscopy or endoscopy findings showing polyps
  • Abdominal pain or gastrointestinal bleeding may be present

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history and physical examination details
  • Procedure notes including type and number of polyps removed
  • Pathology report of excised polyps

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for coding polypectomy versus biopsy
  • Common errors include incorrect diagnosis coding or missing pathology reports

Code Exclusions

Important Exclusions

  • Malignant polyps
  • Polyps requiring surgical resection

Related ICD-10 Codes

Primary Codes
K63.5
Polyp of colon
D12.6
Benign neoplasm of colon
Ancillary Codes
Z12.11
Differential Codes
C18.0
C18.0
if the polyp is confirmed as malignant.
D12.0
D12.0
if the polyp is adenomatous.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Gastroenterology

Specialty Applications

  • Adults undergoing screening or diagnostic colonoscopy
  • Outpatient and inpatient settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Document the indication for the procedure, type of polypectomy performed, and pathology results.

Billing considerations?

Ensure correct coding of the procedure and diagnosis; check for any bundled services.