K63.5 — Polyp of colon
K63.5 is a billable, specific ICD-10-CM code for polyp of colon. It is valid for submission on a claim.
Risk adjustment
K63.5 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
K63.5 is named in 23 Medicare coverage policies — 23 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
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
How K63.5 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K63.5.
- 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
Related codes at this level
Codes that share K63. If K63.5 is not quite right, the correct code is usually one of these.
Questions about K63.5
- Is K63.5 a billable ICD-10-CM code?
- Yes. K63.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K63.5 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Other diseases of intestines (K55-K64).