Wiki 211.4 vs 569.0 which dx to use?


Benson, AZ
Best answers
I hope someone can help me. I am never sure which code to use, the physicians here add their own diagnosis and I have noticed it doesnt seem consistant with these two codes, in procedure notes it will say "three semi-sessile polyps found in rectum, at 15 cm proximal to anus" sometimes they use 211.4 , other times they use 569.0. :confused:Any help would be appreciated. Thanks

Tucson, AZ
Desert Sun Gastroterology
you code from the documentation, many times the provide uses incorrect codes , you may change their codes as long as you do so based on the documentation. You cannot use 211.4 unless there is a path report that is consistent with this code, otherwise you code just the rectal polyp 569.0
Debra-Thank you, this clarifies a lot for me, I am currently still getting my certification and just started working in a GI office. so this part is all new to me. What you said makes sense about having the path report to report the 211.4. Thank you for your help!!

I use 569.0 for non-adenomatous polyps and 211.4 for adenomatous polyps. The pathology report is the source for determining this distinction