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ICD-10 Guide
ICD-10 CodesD12.8

D12.8

Billable

Benign neoplasm of rectum

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

Code Description

ICD-10 D12.8 is a billable code used to indicate a diagnosis of benign neoplasm of rectum.

Key Diagnostic Point:

Benign neoplasms of the rectum are non-cancerous growths that arise from the rectal tissue. These neoplasms can include a variety of histological types, such as adenomas, lipomas, and neurofibromas. While benign, these growths can lead to symptoms such as rectal bleeding, obstruction, or changes in bowel habits, prompting further investigation. Surveillance is essential, as certain types of benign neoplasms, particularly adenomatous polyps, have the potential to progress to colorectal cancer if left untreated. Regular monitoring through colonoscopy is recommended, especially for patients with a history of polyps or familial syndromes that increase the risk of colorectal malignancies. The management of benign rectal neoplasms often involves surgical excision, particularly if they are symptomatic or show signs of dysplasia. Accurate coding of D12.8 is crucial for proper documentation and reimbursement, as it reflects the benign nature of the condition while also indicating the need for surveillance and potential intervention.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of histological types that can be classified under this code.
  • Need for precise documentation of symptoms and surveillance recommendations.
  • Potential for misclassification with malignant neoplasms.
  • Variability in treatment approaches based on the type of neoplasm.

Audit Risk Factors

  • Inadequate documentation of the type of neoplasm.
  • Failure to document surveillance recommendations.
  • Misclassification of benign neoplasms as malignant.
  • Lack of follow-up documentation for patients with a history of neoplasms.

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed descriptions of the neoplasm type, size, and symptoms, along with surveillance plans.

Common Clinical Scenarios

Patients presenting with rectal bleeding or changes in bowel habits requiring colonoscopy.

Billing Considerations

Documentation must clearly differentiate between benign and malignant findings to avoid coding errors.

Surgery

Documentation Requirements

Operative reports detailing the excision of the neoplasm and histopathological findings.

Common Clinical Scenarios

Surgical intervention for symptomatic benign rectal neoplasms.

Billing Considerations

Ensure that the surgical indication aligns with the diagnosis for accurate coding.

Coding Guidelines

Inclusion Criteria

Use D12.8 When
  • According to ICD
  • 10 coding guidelines, D12
  • 8 should be used when a benign neoplasm of the rectum is confirmed through histological examination
  • It is important to document the specific type of neoplasm and any associated symptoms

Exclusion Criteria

Do NOT use D12.8 When
  • Exclusion criteria include any malignant findings or conditions that do not meet the definition of a benign neoplasm

Related ICD-10 Codes

Related CPT Codes

45385CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used for surveillance of benign rectal neoplasms.

Documentation Requirements

Indication for colonoscopy and findings must be documented.

Specialty Considerations

Gastroenterologists should ensure that the reason for the procedure aligns with the diagnosis.

45330CPT Code

Colonoscopy, flexible, with biopsy

Clinical Scenario

When a biopsy is taken from a benign rectal neoplasm.

Documentation Requirements

Biopsy results must be included in the medical record.

Specialty Considerations

Documentation should specify the type of neoplasm and any follow-up plans.

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 documentation and reimbursement. D12.8 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 documentation and reimbursement. D12.8 provides a clear distinction from malignant codes, which is crucial for patient management and surveillance.

Reimbursement & Billing Impact

reimbursement. D12.8 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 D12.8?

Coding D12.8 accurately reflects the presence of a benign neoplasm of the rectum, which is important for appropriate management, surveillance, and reimbursement. It also helps differentiate benign conditions from malignant ones, guiding clinical decision-making.