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v1.0.0
ICD-10 Guide
DiagnosesRectal Polyp

Rectal Polyp

ICD-10 Coding for Rectal Polyp(K62.1, D12.8)

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

Diagnosis Overview

What is Rectal Polyp?
Essential facts and insights about Rectal Polyp

Key Clinical Considerations:

  • Rectal bleeding
  • Change in bowel habits
  • Abdominal pain
  • Key diagnostic tests: Colonoscopy, Biopsy
  • Physical exam findings: Palpable mass on rectal exam

Clinical Information

Clinical Criteria & Documentation Requirements

  • Required documentation elements: Patient history, Symptoms, Diagnostic test results
  • Specific coding terminology: Adenomatous polyp, Hyperplastic polyp
  • Documentation examples: 'Patient presents with rectal bleeding and is found to have a 1 cm adenomatous polyp on colonoscopy.'

Coding Guidelines

Usage Guidelines & Examples

  • Usage guidelines: Use specific codes based on polyp type and location.
  • Common errors: Misclassifying polyp types or failing to document biopsy results.

Code Exclusions

Important Exclusions

  • Excluded conditions: Malignant polyps, Inflammatory bowel disease.
  • Alternative codes: C18.9 (Malignant neoplasm of colon, unspecified) for malignant cases.

Related ICD-10 Codes

Primary Codes
D12.6
Benign neoplasm of rectum
D12.7
Benign neoplasm of rectosigmoid junction
Ancillary Codes
Z83.71_
Z86.010
Differential Codes
D12.8
K62.1

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Gastroenterology

Specialty Applications

  • Patient populations: Adults, particularly those over 50 or with a family history of colorectal cancer.
  • Clinical settings: Outpatient gastroenterology clinics, hospitals.

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 all symptoms, diagnostic findings, and treatment plans.

Billing considerations?

Ensure correct coding of polyp type and any associated procedures.