D12.8 — Benign neoplasm of rectum
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)
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
Related codes at this level
Codes that share D12. If D12.8 is not quite right, the correct code is usually one of these.
- D12.0Benign neoplasm of cecum
- D12.1Benign neoplasm of appendix
- D12.2Benign neoplasm of ascending colon
- D12.3Benign neoplasm of transverse colon
- D12.4Benign neoplasm of descending colon
- D12.5Benign neoplasm of sigmoid colon
- D12.6Benign neoplasm of colon, unspecified
- D12.7Benign neoplasm of rectosigmoid junction
- D12.9Benign neoplasm of anus and anal canal
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 an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.