Wiki Coding - removed or destroyed polyps

[kakie7717]

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Hi Everyone,

We recently had an extensive conversation here about how to properly assign a diagnosis code when a polyp is removed. We have a few of scenerios that we need opinions and confirmation or discussion about:

1) Polyp is removed, pathology comes back and states tubular adenoma, dx given 211.x

2) Polyp is removed, pathology comes back and states "no pathologic diagnosis available", code signs and symptoms or sceening code only. Was being coded with 211.x code because it was a polyp. Opinions needed here.

3) Sessile polyps are destroyed and nothing is sent to pathology. How would this be coded? Indication states History of... should that be it?

Research indicates that a polyp is "precancerous" but with the lack of confirmation, I am hesitant to say go-ahead on always adding the 211.x codes.

Your thoughts?? Thanks in advance for all of the help!

 

[Kisalyn]

I'd be interested in knowing other's oppinions as well. Our office is GI.

1) ...

2) I code 569.89 (colon other disorder) -- this is where we've been questioning our coding. If it's hyperplastic or non diagnostic, is this right/wrong? If it was a screening, we position this behind the v-code.

3) 569.89 coded here as well. For some reason our office has only ever coded neoplasm code 211.X if it's stated adenomatous. At a seminar I was at, the consultant stated it wasn't wrong to code hyperplastic colon polps as 211.3 or 569.89.

Regarding "precancerous," if it's the path report, I code the neoplasm, uncertain behavior codes. Usually our pathologist will state something like borderline malignancy.