Wiki K63.5 & D12.2

Create Wiki Sort by votes
P

pchamp25

Networker
Messages
36
Location
New Durham, NH
Best answers
0
I am coding a procedure where the provider obtained a polyp from the ascending and sigmoid colon. I know that if the path report states hyperplastic you should report K63.5 and if it states adenoma you should use D12 to specify where the specimen was obtained. My question is what if on the path reports one specimen states hyperplastic and one states adenoma, can both codes be reported together? TIA
 
0
K63.5 is an Excludes1 for any D12 code so I would not report them together.

1612374883277.png

ETA: As pointed out by mconner001, there is an exception to the guidelines that I missed. With that additional information, I would code both the polyp and the adenoma because they are in separate anatomical areas.
 
Last edited:
0
While there is an exclude 1 on the use of K63.5 and D12. - there is also an exception per the guidelines. K63.5 hyperplastic polyp and a Benign neoplasm in a separate area could be billable, my rationale is that one carries a concern for turning into cancer and the other does not. Does the exception not apply in the case of K63.5 and D12.- code?
 
0
I missed the exception in the guidelines and I agree they both can be coded - not necessarily due to risk but the fact that they are in completely different areas of the intestine. Thank you for pointing that out. I will edit my original response.
 
You must log in or register to reply here.
Top