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v1.0.0
ICD-10 Guide
ICD-10 CodesD12.7

D12.7

Billable

Benign neoplasm of rectosigmoid junction

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

Code Description

ICD-10 D12.7 is a billable code used to indicate a diagnosis of benign neoplasm of rectosigmoid junction.

Key Diagnostic Point:

A benign neoplasm of the rectosigmoid junction refers to a non-cancerous tumor located at the junction of the rectum and sigmoid colon. These neoplasms can vary in size and may present with symptoms such as rectal bleeding, changes in bowel habits, or abdominal discomfort. Although benign, these tumors can sometimes cause obstruction or other complications depending on their size and location. Surveillance is essential, as certain types of benign neoplasms, such as adenomatous polyps, have the potential to progress to colorectal cancer if left untreated. Regular monitoring through colonoscopy is recommended to assess the neoplasm's characteristics and to ensure that no malignant transformation occurs. The management of these neoplasms often involves surgical intervention, particularly if they are symptomatic or show signs of growth. Accurate coding of this condition is crucial for appropriate treatment planning and resource allocation in healthcare settings.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between benign and malignant neoplasms
  • Understanding the anatomical location and implications of the rectosigmoid junction
  • Monitoring for potential malignant transformation
  • Documentation of symptoms and clinical findings

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to document surveillance plans
  • Misclassification of benign versus malignant neoplasms
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed descriptions of the neoplasm, including size, location, and symptoms.

Common Clinical Scenarios

Patients presenting with rectal bleeding or changes in bowel habits.

Billing Considerations

Ensure that surveillance protocols are documented to justify ongoing monitoring.

Surgery

Documentation Requirements

Operative reports detailing the excision of the neoplasm and any complications.

Common Clinical Scenarios

Surgical intervention for symptomatic benign neoplasms.

Billing Considerations

Document the rationale for surgery and any histopathological findings.

Coding Guidelines

Inclusion Criteria

Use D12.7 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the neoplasm's characteristics
  • Include any relevant symptoms and the patient's history to support the diagnosis

Exclusion Criteria

Do NOT use D12.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

45385CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used for surveillance of benign neoplasms.

Documentation Requirements

Document findings, including size and appearance of neoplasm.

Specialty Considerations

Gastroenterologists should ensure thorough documentation of the procedure and findings.

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 management strategies.

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 management strategies.

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 management strategies.

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 D12.7 accurately?

Accurate coding of D12.7 is crucial for ensuring appropriate management and surveillance of benign neoplasms, which can have implications for patient outcomes and healthcare resource allocation.