K63.5

K63.5: Polyp of colon

Billable / specific codeICD-10-CM

K63.5 is a billable, specific ICD-10-CM code for polyp of colon. It is valid for submission on a claim.

Check K63.5 with the rest of the claim: free scrubber

Excludes2: not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

adenomatous polyp of colon (D12.-)
inflammatory polyp of colon (K51.4-)
polyposis of colon (D12.6)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

K63.5 is named in 21 Medicare coverage policies: 21 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A55937Billing and Coding: Diagnostic Colonoscopy
A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
A56421Billing and Coding: CT of the Abdomen and Pelvis
A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

Alphabetic index entries that lead here

Polyp, polypus›cecum
Polyp, polypus›colon
Polyp, polypus›colon›ascending
Polyp, polypus›colon›cecum
Polyp, polypus›colon›descending
Polyp, polypus›colon›hyperplastic,(any site)
Polyp, polypus›colon›sigmoid
Polyp, polypus›colon›transverse

Code history

Unchanged in every release from FY2024 to FY2027.