Is D12.8 a billable ICD-10-CM code?

Yes. D12.8 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D12.8 sit in the tabular list?

Neoplasms (C00-D49), in the block Benign neoplasms, except benign neuroendocrine tumors (D10-D36).

What cannot be coded together with D12.8?

D12.8 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter.

D12.8

D12.8 — Benign neoplasm of rectum

Billable / specific codeICD-10-CM

D12.8 is a billable, specific ICD-10-CM code for benign neoplasm of rectum. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

benign carcinoid tumor of the rectum (D3A.026)

Excludes2 inherited from the categories above D12.8

Also inherited, and the opposite of Excludes1: these conditions are not part of D12.8, but a patient can have both, so you may code both.

Written on D12 — Benign neoplasm of colon, rectum, anus and anal canal

benign carcinoid tumors of the large intestine and rectum (D3A.02-)
polyp of colon NOS (K63.5)

Other codes that can never be billed with D12.8

These codes carry an Excludes1 note pointing at D12.8. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D12.8 alone.

K62.1Rectal polyp

Risk adjustment

D12.8 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

D12.8 is named in 16 Medicare coverage policies — 16 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A55937Billing and Coding: Diagnostic Colonoscopy
A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax

Code history

D12.8 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share D12. If D12.8 is not quite right, the correct code is usually one of these.

Questions about D12.8

Is D12.8 a billable ICD-10-CM code?: Yes. D12.8 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D12.8 sit in the tabular list?: Neoplasms (C00-D49), in the block Benign neoplasms, except benign neuroendocrine tumors (D10-D36).
What cannot be coded together with D12.8?: D12.8 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter.